Provider Demographics
NPI:1942623111
Name:PERFECTED HOME CARE INC.
Entity type:Organization
Organization Name:PERFECTED HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRI
Authorized Official - Middle Name:
Authorized Official - Last Name:GODBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL DOCTOR
Authorized Official - Phone:248-855-1956
Mailing Address - Street 1:31500 W 13 MILE RD
Mailing Address - Street 2:STE 104
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2164
Mailing Address - Country:US
Mailing Address - Phone:248-855-1956
Mailing Address - Fax:248-855-1977
Practice Address - Street 1:31500 W 13 MILE RD
Practice Address - Street 2:104
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2164
Practice Address - Country:US
Practice Address - Phone:248-855-1956
Practice Address - Fax:248-855-1977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080880207R00000X
MI4301080800207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty