Provider Demographics
NPI:1598814501
Name:A.N.N. INC.
Entity Type:Organization
Organization Name:A.N.N. INC.
Other - Org Name:AT HOME NETWORK, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWQI
Authorized Official - Middle Name:E
Authorized Official - Last Name:HALABU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-987-1320
Mailing Address - Street 1:20282 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-2002
Mailing Address - Country:US
Mailing Address - Phone:248-987-1320
Mailing Address - Fax:248-987-1326
Practice Address - Street 1:20282 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2002
Practice Address - Country:US
Practice Address - Phone:248-987-1320
Practice Address - Fax:248-987-1326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237407OtherMEDICARE PROVIDER NUMBER
MI15 4536377OtherMEDICAID PROVIDER NUMBER