Provider Demographics
NPI:1194100230
Name:ADULT ASSISTED TRANSITIONAL HOMES INC
Entity type:Organization
Organization Name:ADULT ASSISTED TRANSITIONAL HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-354-9070
Mailing Address - Street 1:24225 W 9 MILE RD STE 108
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3990
Mailing Address - Country:US
Mailing Address - Phone:248-354-9070
Mailing Address - Fax:248-354-9077
Practice Address - Street 1:24225 W 9 MILE RD STE 108
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-3990
Practice Address - Country:US
Practice Address - Phone:248-354-9070
Practice Address - Fax:248-354-9077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0053761Medicaid