Provider Demographics
NPI:1871615450
Name:ENHANCED LIVING SOLUTIONS, LLC
Entity type:Organization
Organization Name:ENHANCED LIVING SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-568-6112
Mailing Address - Street 1:8194 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-8673
Mailing Address - Country:US
Mailing Address - Phone:734-568-6008
Mailing Address - Fax:734-568-6010
Practice Address - Street 1:8194 SECOR ROAD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9737
Practice Address - Country:US
Practice Address - Phone:734-568-6008
Practice Address - Fax:734-568-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5995470001Medicare NSC