Provider Demographics
NPI:1164854980
Name:A&R PREMIERE CARE
Entity Type:Organization
Organization Name:A&R PREMIERE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTLY
Authorized Official - Middle Name:DEAUN
Authorized Official - Last Name:REDDICK
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:734-439-8125
Mailing Address - Street 1:12245 ALLISON RD
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-9145
Mailing Address - Country:US
Mailing Address - Phone:734-439-8125
Mailing Address - Fax:
Practice Address - Street 1:12245 ALLISON RD
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160-9145
Practice Address - Country:US
Practice Address - Phone:734-439-8125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAF580338269253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency