MEDICARE: AT HOME HEALTH SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		MI

General Provider Information

NPI Number	:	1144332750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT HOME HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	8898 COMMERCE RD STE 2B
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-4485
Country	:	US
Telephone Number	:	248-242-4720
Fax Number	:	248-242-4721

Provider Business Practice Location Address
First Line	:	8898 COMMERCE RD STE 2B
Second Line	:
City	:	COMMERCE TOWNSHIP
State	:	MI
Zip	:	48382-4485
Country	:	US
Telephone Number	:	248-242-4720
Fax Number	:	248-242-4721

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	FRANK COSTA
Credential	:
Telephone Number	:	248-242-4720

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/31/2020

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