Provider Demographics
NPI:1992984660
Name:NATALIS HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:NATALIS HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MARKETING & OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:LYNTRICE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAADC, SAP
Authorized Official - Phone:313-964-2648
Mailing Address - Street 1:PO BOX 44805
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48244-0805
Mailing Address - Country:US
Mailing Address - Phone:313-964-2648
Mailing Address - Fax:186-646-8958
Practice Address - Street 1:155 W. CONGRESS
Practice Address - Street 2:SUITE 306
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-3272
Practice Address - Country:US
Practice Address - Phone:313-964-2648
Practice Address - Fax:866-468-9584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00000000Medicare Oscar/Certification