Provider Demographics
NPI:1528629870
Name:EZ CARE LLC
Entity type:Organization
Organization Name:EZ CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GRIGORIY
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-942-4386
Mailing Address - Street 1:15565 NORTHLAND DR E STE 910E
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15565 NORTHLAND DR E STE 910E
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5331
Practice Address - Country:US
Practice Address - Phone:248-924-4386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME HEALTH AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000OtherN/A