Provider Demographics
NPI:1306602891
Name:ATARAH CARSHENA WARE, LLC
Entity type:Organization
Organization Name:ATARAH CARSHENA WARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ATARAH CARSHENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:248-678-3131
Mailing Address - Street 1:19961 WOODWORTH
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-1125
Mailing Address - Country:US
Mailing Address - Phone:248-678-3131
Mailing Address - Fax:
Practice Address - Street 1:19961 WOODWORTH
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-1125
Practice Address - Country:US
Practice Address - Phone:248-678-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty