Organization
AVISTA HOME HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AVIS HANY CHOULAGH J.D. (ADMINISTRATOR)
(586) 405-0341
Entity
Organization
Contact information
Practice address
5237 OAKMAN BLVD STE D, DEARBORN, MI 48126-4045
(586) 405-0341
Mailing address
5237 OAKMAN BLVD STE D, DEARBORN, MI 48126-4045
(586) 405-0341
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/11/2009
Last updated
10/13/2009
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