Provider Demographics
NPI:1811758717
Name:MARY ROSE HOME CARE LLC
Entity type:Organization
Organization Name:MARY ROSE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAFAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-931-4122
Mailing Address - Street 1:34119 W 12 MILE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3300
Mailing Address - Country:US
Mailing Address - Phone:248-931-4122
Mailing Address - Fax:248-332-1583
Practice Address - Street 1:34119 W 12 MILE RD STE 201
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3300
Practice Address - Country:US
Practice Address - Phone:248-939-1967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care