| Organization Name: | HOME MDS L.L.C |
| NPI Number: | 1679739122 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FANNY AGUIRRE DELA CRUZ (ADMINISTRATIVE DIRECTOR) |
| Mailing Address: | 17880 Farmington Rd Unit B Livonia |
| State: | MI US |
| Postal Code: | 481523104 |
| Phone Number: | 7347448560 |
| Fax Number: | 7347448563 |
| NPI Enumeration Date: | 08/04/2008 |
| NPI Last Update Date: | 08/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 36977 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |