Provider Demographics
NPI:1285960831
Name:ATLANTIC HOME HEALTH, INC
Entity type:Organization
Organization Name:ATLANTIC HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:BOUDREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1888-880-6193
Mailing Address - Street 1:30 FOREST FALLS DR STE 5
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6983
Mailing Address - Country:US
Mailing Address - Phone:188-888-0619
Mailing Address - Fax:207-847-2017
Practice Address - Street 1:30 FOREST FALLS DR STE 5
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6983
Practice Address - Country:US
Practice Address - Phone:188-888-0619
Practice Address - Fax:207-847-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME02919251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health