Provider Demographics
NPI:1437494846
Name:AMERICAN ADVANTAGE HOME CARE, INC.
Entity Type:Organization
Organization Name:AMERICAN ADVANTAGE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLEAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:313-740-9716
Mailing Address - Street 1:2040 MONROE ST STE 208
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2950
Mailing Address - Country:US
Mailing Address - Phone:313-914-2296
Mailing Address - Fax:313-436-4152
Practice Address - Street 1:2040 MONROE ST STE 208
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2950
Practice Address - Country:US
Practice Address - Phone:313-914-2296
Practice Address - Fax:313-436-4152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health