Provider Demographics
NPI:1366723520
Name:PATRIOT HOMECARE, INC.
Entity type:Organization
Organization Name:PATRIOT HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-977-1500
Mailing Address - Street 1:38600 VAN DYKE AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1170
Mailing Address - Country:US
Mailing Address - Phone:586-977-1500
Mailing Address - Fax:586-977-1503
Practice Address - Street 1:38600 VAN DYKE AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-1170
Practice Address - Country:US
Practice Address - Phone:586-977-1500
Practice Address - Fax:586-977-1503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health