Basic Information
| Provider Information | |||||||||
| NPI: | 1215412515 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRE HRW INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30700 TELEGRAPH RD STE 1645 | ||||||||
| Address2: | |||||||||
| City: | BINGHAM FARMS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480254525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482831100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 23450 ONEIDA ST | ||||||||
| Address2: | |||||||||
| City: | OAK PARK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482372242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488367575 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2018 | ||||||||
| LastUpdateDate: | 10/02/2018 | ||||||||
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| AuthorizedOfficialLastName: | KAZKAZ | ||||||||
| AuthorizedOfficialFirstName: | MOHAMED | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2488367575 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374U00000X | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Related Providers | Home Health Aide | 251E00000X | Y | Agencies | Home Health |
No ID Information.