Organization
ADULT HOME HELP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE MAZIQUE (HOME HELP)
(989) 790-3167
Entity
Organization
Contact information
Practice address
4071 GREEN ISLE WAY, #2, SAGINAW, MI 48603-1416
(989) 790-3167
Mailing address
4071 GREEN ISLE WAY, #2, SAGINAW, MI 48603-1416
(989) 790-3167
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
007386671
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
358365794B6
MEDICARE CLAIM NUMBER
MI
01
—
77386671
MIHEALTH CARD
MI
Enumeration date
01/31/2016
Last updated
01/31/2016
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