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General NPI Number Information
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NPI Number | 1932848587
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Entity Type | Organization
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Legal Business Name | ATLANTIC HOME HEALTH LLC
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Dates
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Enumeration Date | 06/01/2022
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 583 CHESTNUT ST STE 5
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City | LYNN
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State | MA
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Zip | 01904-2600
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Country | US
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Telephone | 978-662-2050
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Fax | 877-500-8285
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Provider Business Mailing Address
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Address Line | 583 CHESTNUT ST STE 5
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City | LYNN
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State | MA
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Zip | 01904-2600
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Country | US
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Telephone | 978-662-2050
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Fax | 877-500-8285
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Authorized Official
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Title or Position | CEO
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Name | MR. MAHRAY GEBREMICHAEL
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Credential |
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Telephone | 978-662-2050
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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 |
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License Number State |
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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 |
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License Number State |
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