Organization
HARLEYS HART HOME HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANNA DENISE TYE LPN (CEO)
(248) 929-2930
Entity
Organization
Contact information
Practice address
17520 W 12 MILE RD STE 109, SOUTHFIELD, MI 48076-1907
(248) 929-2930
Mailing address
25535 CATALINA ST, SOUTHFIELD, MI 48075-1774
(248) 929-2930
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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