Organization
BLUE CROSS HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY GRAY (CREDENTIALING)
(941) 377-7622
Entity
Organization
Contact information
Practice address
9000 E JEFFERSON AVE, STE 14-2, DETROIT, MI 48214-4188
(954) 601-6117
Mailing address
9000 E JEFFERSON AVE, STE 14-2, DETROIT, MI 48214-4188
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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