Provider Demographics
NPI:1720693393
Name:AT HOME DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:AT HOME DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUGAS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:248-466-0806
Mailing Address - Street 1:8323 MABLEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-9455
Mailing Address - Country:US
Mailing Address - Phone:248-466-0806
Mailing Address - Fax:810-244-0226
Practice Address - Street 1:2075 E WEST MAPLE RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-3816
Practice Address - Country:US
Practice Address - Phone:248-466-0806
Practice Address - Fax:810-244-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No251E00000XAgenciesHome Health