Organization
PROVISION HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN MY BUI (PRESIDENT)
(248) 852-4100
Entity
Organization
Contact information
Practice address
2888 E LONG LAKE RD STE 127, TROY, MI 48085-3793
(247) 852-1700
(248) 852-4802
Mailing address
2888 E LONG LAKE RD STE 127, TROY, MI 48085-3793
(247) 852-1700
(248) 852-4802
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528001823
BCBS
MI
Enumeration date
06/14/2006
Last updated
06/30/2020
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