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General NPI Number Information
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NPI Number | 1649568726
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Entity Type | Organization
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Legal Business Name | AA HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 07/11/2011
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Provider Practice Location Address
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Address Line | 55 N POND DR STE 1
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City | WALLED LAKE
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State | MI
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Zip | 48390-3080
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Country | US
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Telephone | 248-905-1626
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Fax |
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Provider Business Mailing Address
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Address Line | 55 N POND DR STE 1
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City | WALLED LAKE
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State | MI
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Zip | 48390-3080
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STELLA SHOR
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Credential |
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Telephone | 248-905-1626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | D6229H
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | D6229H
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License Number State | MI
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