Healthcare Provider Details

I. General information

NPI: 1043444250
Provider Name (Legal Business Name): GANTON HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 06/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 SPRING ARBOR RD
JACKSON MI
49201-9301
US

IV. Provider business mailing address

2121 ROBINSON RD
JACKSON MI
49203-3658
US

V. Phone/Fax

Practice location:
  • Phone: 517-990-6444
  • Fax: 517-990-6447
Mailing address:
  • Phone: 517-787-4150
  • Fax: 517-787-4708

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN GANTON
Title or Position: OWNER
Credential:
Phone: 517-787-4150