Organization
INDEPENDENT HOME CARE OF MICHIGAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY KATHRYN CLARK RN CCM (OWNER)
(810) 750-2713
Entity
Organization
Contact information
Practice address
13280 OLD OAKS DR, FENTON, MI 48430-9497
(810) 750-2713
(810) 714-2386
Mailing address
13280 OLD OAKS DR, FENTON, MI 48430-9497
(810) 750-2713
(810) 714-2386
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
MI
251E00000X
Home Health Agency
Primary
—
MI
Other
Enumeration date
03/01/2009
Last updated
03/01/2009
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