Provider Demographics
NPI:1952508913
Name:ADAPTIVE HOME CARE, INC.
Entity Type:Organization
Organization Name:ADAPTIVE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIST
Authorized Official - Middle Name:
Authorized Official - Last Name:GORGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-983-2590
Mailing Address - Street 1:2295 METROPOLITAN PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4293
Mailing Address - Country:US
Mailing Address - Phone:586-983-2590
Mailing Address - Fax:586-983-2593
Practice Address - Street 1:2295 METROPOLITAN PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4293
Practice Address - Country:US
Practice Address - Phone:586-983-2590
Practice Address - Fax:586-983-2593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1952508913Medicaid
MIOE064OtherBCBSM
MI1952508913Medicaid