Provider Demographics
NPI:1831282003
Name:AMENITY HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:AMENITY HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSELITO
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTANISLAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-803-1690
Mailing Address - Street 1:42874 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-3256
Mailing Address - Country:US
Mailing Address - Phone:586-803-1690
Mailing Address - Fax:586-803-1691
Practice Address - Street 1:42874 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-3256
Practice Address - Country:US
Practice Address - Phone:586-803-1690
Practice Address - Fax:586-803-1691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4855118Medicaid
MI4855118Medicaid