Provider Demographics
NPI:1386159101
Name:CHERISH HOME CARE AGENCY L.L.C.
Entity type:Organization
Organization Name:CHERISH HOME CARE AGENCY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS-CAPARAOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-404-3114
Mailing Address - Street 1:21735 CHERRY BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-4391
Mailing Address - Country:US
Mailing Address - Phone:586-404-3114
Mailing Address - Fax:810-213-9825
Practice Address - Street 1:21735 CHERRY BLOSSOM CT
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-4391
Practice Address - Country:US
Practice Address - Phone:586-404-3114
Practice Address - Fax:810-213-9825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care