Healthcare Provider Details

I. General information

NPI: 1669667838
Provider Name (Legal Business Name): A AND L HOMES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20474 BOURASSA AVE
BROWNSTOWN TWP MI
48183-5057
US

IV. Provider business mailing address

14224 LYONS ST
LIVONIA MI
48154-4632
US

V. Phone/Fax

Practice location:
  • Phone: 734-671-8903
  • Fax:
Mailing address:
  • Phone: 734-421-0959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. AGNES CHONTOS
Title or Position: DIRECTOR
Credential:
Phone: 734-421-0959