Provider Demographics
NPI:1932848587
Name:ATLANTIC HOME HEALTH LLC
Entity Type:Organization
Organization Name:ATLANTIC HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHRAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBREMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-662-2050
Mailing Address - Street 1:200 SUTTON ST STE 135
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1651
Mailing Address - Country:US
Mailing Address - Phone:978-662-2050
Mailing Address - Fax:877-500-8285
Practice Address - Street 1:583 CHESTNUT ST STE 5
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-2600
Practice Address - Country:US
Practice Address - Phone:978-662-2050
Practice Address - Fax:877-500-8285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health