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General NPI Number Information
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NPI Number | 1114385390
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Entity Type | Organization
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Legal Business Name | AT HOME AGAIN CARE SERVICES LLC
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 1400 MIDLAND BLVD
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City | ROYAL OAK
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State | MI
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Zip | 48073-2892
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Country | US
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Telephone | 248-894-8248
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Fax | 888-338-9319
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Provider Business Mailing Address
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Address Line | 1400 MIDLAND BLVD
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City | ROYAL OAK
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State | MI
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Zip | 48073-2892
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Country | US
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Telephone | 248-894-8248
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Fax | 888-338-9319
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TANYA LITTLE
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Credential |
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Telephone | 248-894-8248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | AS630349512
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License Number State | MI
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