Provider Demographics
NPI:1871308965
Name:MGM HOME CARE & STAFFING, LLC
Entity type:Organization
Organization Name:MGM HOME CARE & STAFFING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:SHARRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-769-4789
Mailing Address - Street 1:470 COMMONS BLVD APT C
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-1152
Mailing Address - Country:US
Mailing Address - Phone:517-769-4789
Mailing Address - Fax:
Practice Address - Street 1:1101 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3113
Practice Address - Country:US
Practice Address - Phone:517-769-4789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health