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General NPI Number Information
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NPI Number | 1689800161
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Entity Type | Organization
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Legal Business Name | EARBY HOME INC
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 05/31/2012
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Provider Practice Location Address
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Address Line | 26310 CARLYSLE ST
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City | INKSTER
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State | MI
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Zip | 48141-2651
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Country | US
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Telephone | 313-277-6715
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Fax |
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Provider Business Mailing Address
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Address Line | 26310 CARLYSLE
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City | INKSTER
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State | MI
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Zip | 48141
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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 | ALANA LOUISE EARBY
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Credential |
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Telephone | 313-277-6715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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