Healthcare Provider Details

I. General information

NPI: 1245191683
Provider Name (Legal Business Name): ADERITO TOMAS DELEON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2619 GROESBECK AVE
LANSING MI
48912-4519
US

IV. Provider business mailing address

2775 E LANSING DR
EAST LANSING MI
48823-7755
US

V. Phone/Fax

Practice location:
  • Phone: 517-285-6033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: