Provider Demographics
NPI:1447071824
Name:DAVID HOME CARE LLC
Entity type:Organization
Organization Name:DAVID HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIGGITTEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-670-6909
Mailing Address - Street 1:23900 OUTER DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MELVINDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48122-1646
Mailing Address - Country:US
Mailing Address - Phone:248-670-6909
Mailing Address - Fax:
Practice Address - Street 1:23900 OUTER DR STE 2
Practice Address - Street 2:
Practice Address - City:MELVINDALE
Practice Address - State:MI
Practice Address - Zip Code:48122-1646
Practice Address - Country:US
Practice Address - Phone:248-670-6909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAVID HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty