Organization
MAXICARE HOME HEALTH AGENCY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ISABEL D TCRUZ (PRESIDENT/ CEO)
(586) 293-1600
Entity
Organization
Contact information
Practice address
28909 UTICA ROAD, ROSEVILLE, MI 48066
(586) 293-1600
(586) 293-1617
Mailing address
28909 UTICA ROAD, ROSEVILLE, MI 48066
(586) 293-1600
(586) 293-1617
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
N/A
MI
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E928
BCBS
MI
05
—
154376433
—
MI
Enumeration date
06/08/2005
Last updated
04/07/2014
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