Residential Home Healthcare

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

5101006690 Issued in MI

Legal business name

RESIDENTIAL HOME HEALTHCARE

Practice address

11477 E 12 Mile Rd
Warren, MI 48093-2678

Phone

(586) 751-0200

Fax

(586) 751-0414

NPI assigned

Nov 6, 2014

Last updated

Nov 6, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jeff Micheal Mastin

Title

Administrative Assistant

Phone

(586) 751-0200

Specialties & licenses 7

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1902202716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11477 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932678",
            "telephone_number": "586-751-0200",
            "fax_number": "586-751-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11477 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932678",
            "telephone_number": "586-751-0200",
            "fax_number": "586-751-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL HOME HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "MASTIN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "MICHEAL",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "586-751-0200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MI",
            "license": "5901000447",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MI",
            "license": "5901001570",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MI",
            "license": "5901000468",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301025138",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301046450",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301095717",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "5101006690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renaissance Physical Therapy LLC
• Renal Treatment Centers-Illinois Inc. (Macomb Kidney Center)
• Elizabeth Hannah Rengers, DO
• Renova Surgical Center LLC
• Residential Home Care Inc
• Resilience Psychotherapy Services LLC
• Jeffrey Richard Respecki, D.O.
• Kenneth Howard Retford, D.D.S.
• Brent Reusser, D.O.
• Terry Lynn Revere, O.T.

• Primary Care Clinic/Center in Warren, MI
• Providers in Warren, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.