Provider Demographics
NPI:1902856453
Name:ATLAS HOME HEALTH LLC
Entity Type:Organization
Organization Name:ATLAS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAURAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-342-8527
Mailing Address - Street 1:576 ROMENCE RD
Mailing Address - Street 2:SUITE 223
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-3472
Mailing Address - Country:US
Mailing Address - Phone:269-342-8527
Mailing Address - Fax:269-342-2995
Practice Address - Street 1:576 ROMENCE RD
Practice Address - Street 2:SUITE 223
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-3472
Practice Address - Country:US
Practice Address - Phone:269-342-8527
Practice Address - Fax:269-342-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health