Provider Demographics
NPI:1730549403
Name:ANNTHONY ROCKETTE
Entity type:Organization
Organization Name:ANNTHONY ROCKETTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOME HELP AIDE
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROCKETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-265-5141
Mailing Address - Street 1:6395 AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3910
Mailing Address - Country:US
Mailing Address - Phone:313-265-5141
Mailing Address - Fax:
Practice Address - Street 1:6395 AUBURN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3910
Practice Address - Country:US
Practice Address - Phone:313-265-5141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health