Provider Demographics
NPI:1285860577
Name:AERIAL HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:AERIAL HOME HEALTH CARE, INC
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SUBASTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGMENT
Authorized Official - Phone:586-504-4480
Mailing Address - Street 1:19751 E 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-3908
Mailing Address - Country:US
Mailing Address - Phone:586-504-4480
Mailing Address - Fax:248-423-6595
Practice Address - Street 1:19751 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48035-3908
Practice Address - Country:US
Practice Address - Phone:586-504-4480
Practice Address - Fax:248-423-6595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
MI0000000065302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI999999000Medicare Oscar/Certification
MI1234999990Medicare NSC