Healthcare Provider Details

I. General information

NPI: 1295433456
Provider Name (Legal Business Name): ATLANTIC HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E 14TH ST
SILVER CITY NM
88061-5559
US

IV. Provider business mailing address

885 PENNIMAN AVE UNIT 6426
PLYMOUTH MI
48170-7722
US

V. Phone/Fax

Practice location:
  • Phone: 866-259-1864
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW SAAGMAN
Title or Position: MANAGER
Credential:
Phone: 734-228-8388