Provider Demographics
NPI:1366149528
Name:EXPERIENCE THIS HOME CARE L.L.C.
Entity type:Organization
Organization Name:EXPERIENCE THIS HOME CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:248-842-2662
Mailing Address - Street 1:454 FAY CT
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-1846
Mailing Address - Country:US
Mailing Address - Phone:248-842-2662
Mailing Address - Fax:
Practice Address - Street 1:454 FAY CT
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-1846
Practice Address - Country:US
Practice Address - Phone:248-842-2662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health