Provider Demographics
NPI:1629852405
Name:AT HOME CHORE SERVICES, LLC
Entity Type:Organization
Organization Name:AT HOME CHORE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAVIS-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-977-0563
Mailing Address - Street 1:37 N ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2901
Mailing Address - Country:US
Mailing Address - Phone:248-977-0563
Mailing Address - Fax:248-484-6641
Practice Address - Street 1:37 N ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2901
Practice Address - Country:US
Practice Address - Phone:248-977-0563
Practice Address - Fax:248-484-6641
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHNSON'S MEDICAL SUPPLY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1063536571Medicaid