Organization
MY HOME MD, PLCC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM H. HAITHCO (EXECUTIVE DIRECTOR)
(586) 558-9545
Entity
Organization
Contact information
Practice address
28855 VAN DYKE AVE, WARREN, MI 48093-2744
(586) 558-9545
(586) 558-9541
Mailing address
28855 VAN DYKE AVE, WARREN, MI 48093-2744
(586) 558-9545
(586) 558-9541
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/07/2005
Last updated
08/22/2020
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