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Organization
COUNTRY CLUB HOME CARE LLC
Active
Organization
COUNTRY CLUB HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSE MARIE MANSEL REGISTERED NURSE (OWNER)
(248) 346-1233
Entity
Organization
Contact information
Practice address
6477 HERITAGE, WEST BLOOMFIELD, MI 48322-1339
(866) 596-9111
(866) 596-9111
Mailing address
2554 S ROCHESTER RD, ROCHESTER HILLS, MI 48307-3817
(866) 596-9111
(866) 596-9111
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
4704245086
MI
Other
Enumeration date
12/21/2010
Last updated
12/21/2010
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