Provider Demographics
NPI:1134124332
Name:ADVANCED PROFESSIONAL HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:ADVANCED PROFESSIONAL HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:AMER
Authorized Official - Middle Name:MAHMUD
Authorized Official - Last Name:SUFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-649-5250
Mailing Address - Street 1:2075 W BIG BEAVER RD
Mailing Address - Street 2:SUITE # 602
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3407
Mailing Address - Country:US
Mailing Address - Phone:248-649-5250
Mailing Address - Fax:248-649-5417
Practice Address - Street 1:2075 W BIG BEAVER RD
Practice Address - Street 2:SUITE # 602
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3407
Practice Address - Country:US
Practice Address - Phone:248-649-5250
Practice Address - Fax:248-649-5417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI237075251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E050OtherBCBSM HEALTH INSURANCE
KY49425OtherCOVENTRY HEALTH INSURANCE
MI15-5174076Medicaid
237075Medicare ID - Type Unspecified