Provider Demographics
NPI:1699194043
Name:NEW LIFE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:NEW LIFE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENYATTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-914-0718
Mailing Address - Street 1:5860 STERLING DR STE 360
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8861
Mailing Address - Country:US
Mailing Address - Phone:248-914-0718
Mailing Address - Fax:
Practice Address - Street 1:5860 STERLING DR STE 360
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8861
Practice Address - Country:US
Practice Address - Phone:248-914-0718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251B00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management