Provider Demographics
NPI:1700103348
Name:AMBIENT TRANSIENT HOME CARE INC
Entity Type:Organization
Organization Name:AMBIENT TRANSIENT HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAPHNE
Authorized Official - Middle Name:SONYA
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LIC RRT
Authorized Official - Phone:734-585-7252
Mailing Address - Street 1:696 N MILL ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1452
Mailing Address - Country:US
Mailing Address - Phone:734-585-7252
Mailing Address - Fax:
Practice Address - Street 1:696 N MILL ST
Practice Address - Street 2:SUITE 108
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1452
Practice Address - Country:US
Practice Address - Phone:734-585-7252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4401003872251E00000X, 251F00000X, 253Z00000X, 332B00000X, 332BX2000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)