Provider Demographics
NPI:1699058198
Name:A & T PRIVATE CARE SERVICES
Entity type:Organization
Organization Name:A & T PRIVATE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BAHS
Authorized Official - Phone:586-404-5243
Mailing Address - Street 1:17116 SPRENGER AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-4501
Mailing Address - Country:US
Mailing Address - Phone:586-404-5243
Mailing Address - Fax:586-777-4159
Practice Address - Street 1:17116 SPRENGER AVE
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-4501
Practice Address - Country:US
Practice Address - Phone:586-404-5243
Practice Address - Fax:586-777-4159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care