Provider Demographics
NPI:1902786973
Name:MIIKO GROUP HOME LLC
Entity type:Organization
Organization Name:MIIKO GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:N
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-276-1434
Mailing Address - Street 1:3237 MONUMENT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2247
Mailing Address - Country:US
Mailing Address - Phone:734-276-1434
Mailing Address - Fax:
Practice Address - Street 1:3237 MONUMENT
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2247
Practice Address - Country:US
Practice Address - Phone:734-276-1434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)