Organization Active NPI

Quality Home Health Care Services of Michigan,Inc.

  • Home Health Agency
  • Southfield, MI
National Provider Identifier
1407818172
Registry record updated May 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
237482 Issued in MI
Legal business name
QUALITY HOME HEALTH CARE SERVICES OF MICHIGAN,INC.
Practice address
23800 West.Ten Mile Rd
Ste 250
Southfield, MI 48034
Phone
(248) 350-0014
NPI assigned
Apr 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael C Gilliam, M.B.A.
Title
President/Ceo
Phone
(313) 410-8870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 237482 MI Primary

Addresses

Primary practice location

23800 West.Ten Mile Rd
Ste 250
Southfield, MI 48034

Mailing address

23800 West.Ten Mile Rd. Ste 250
Southfield, MI 48034
Phone (248) 350-0014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100528000440 MI Part A Provider - Home Health Agency 4082743000 Practice locations: Southfield, MI

Home health agency certification: CCN 237482

Legal name
QUALITY HOME HEALTH CARE SERVICES OF MICHIGAN,INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 12, 2003
Last certification
Mar 13, 2003
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 7, 2001 in MI
Enrollment address
23800 W 10 Mile Rd
Ste 250
Southfield, MI 48033-3150

Care Compare: Home health agency

Medicare Care Compare
Listed as
Quality Home Health Care Services of MichiganCCN 237482 · All quality measures
Ownership
Proprietary
Certified
Mar 12, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0998352Quality Home Health Care Services23800 W Ten Mile Road, Suite 250, Southfield, MI 48034Certificate of waiverApr 11, 2028

National Provider Directory

National Provider Directory

Locations

23800 W 10 Mile Rd
Ste 250
Southfield, MI 48033
Phone (248) 304-4467

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Generosa F Agustin Individual 5% Or Greater Direct Ownership InterestOwner Apr 16, 2002 49%
Corporate OfficerMember - Board of Directors Jun 2, 2020 33.03%
Operational/Managerial ControlCeo/Administrator Jun 2, 2020 100%
Mychael T. Gilliam Individual 5% Or Greater Direct Ownership Interest Jun 2, 2020 25.5%
Corporate OfficerMember - Board of Directors Jun 2, 2020 33.3%
Sharde B. Gilliam Individual 5% Or Greater Direct Ownership Interest Jun 2, 2020 25.5%
Corporate OfficerMember - Board of Directors Jun 2, 2020 33.3%

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275004800000",
    "number": "1407818172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23800 WEST.TEN MILE RD. STE 250",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48034",
            "telephone_number": "248-350-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23800 WEST.TEN MILE RD",
            "address_2": "STE 250",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48034",
            "telephone_number": "248-350-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY HOME HEALTH CARE SERVICES OF MICHIGAN,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2010-05-28",
        "status": "A",
        "authorized_official_last_name": "GILLIAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "313-410-8870",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.B.A."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": "237482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.