Healthcare Provider Details

I. General information

NPI: 1285860577
Provider Name (Legal Business Name): AERIAL HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19751 E 14 MILE RD
CLINTON TWP MI
48035-3908
US

IV. Provider business mailing address

19751 E 14 MILE RD
CLINTON TWP MI
48035-3908
US

V. Phone/Fax

Practice location:
  • Phone: 586-504-4480
  • Fax: 248-423-6595
Mailing address:
  • Phone: 586-504-4480
  • Fax: 248-423-6595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number0000000065
License Number StateMI

VIII. Authorized Official

Name: GREGORY JOHN SUBASTIAN
Title or Position: PRESIDENT
Credential: MANAGMENT
Phone: 586-504-4480