Provider Demographics
NPI:1275691636
Name:AARDVARK HOME CARE CORPORATION
Entity Type:Organization
Organization Name:AARDVARK HOME CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:734-925-4140
Mailing Address - Street 1:20600 EUREKA RD STE 325
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-5371
Mailing Address - Country:US
Mailing Address - Phone:734-925-4140
Mailing Address - Fax:734-796-2006
Practice Address - Street 1:20600 EUREKA RD STE 325
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5371
Practice Address - Country:US
Practice Address - Phone:734-925-4140
Practice Address - Fax:734-796-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health