Organization Active NPI

Classic Home Health Services Inc

  • Home Health Agency
  • Dearborn Heights, MI
National Provider Identifier
1497057632
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CLASSIC HOME HEALTH SERVICES INC
Practice address
4245 Beech Daly
Suite B
Dearborn Heights, MI 48125-1576
Phone
(313) 633-0765
Fax
(313) 633-0938
NPI assigned
Nov 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Authorized official

Name
Tarique Pervez
Title
President
Phone
(313) 633-0765

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4245 Beech Daly
Suite B
Dearborn Heights, MI 48125-1576

Mailing address

4245 Beech Daly
Suite B
Dearborn Heights, MI 48125-1576
Phone (313) 633-0765

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101130001326 MI Part A Provider - Home Health Agency 0345436457 Practice locations: Dearborn Heights, MI

Home health agency certification: CCN 239224

Legal name
CLASSIC HOME HEALTH SERVICES INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 16, 2012
Last certification
Jan 27, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 4, 2010 in MI
Enrollment address
4245 S Beech Daly St
Ste B
Dearborn Heights, MI 48125-1576
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Classic Home Health Services, IncCCN 239224
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Mar 16, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, 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
23D2025152Classic Home Health Services Inc4245 Beech Daly, Suite B, Dearborn Heights, MI 48125Certificate of waiverJun 1, 2027

National Provider Directory

National Provider Directory

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
Abed Al Wahhab M Mostafa Individual W-2 Managing EmployeeClinical Manager Oct 22, 2014 50%
Tarique Pervez Individual W-2 Managing EmployeeAdministrator Jan 1, 2016 50%
Zafar a Khan Individual 5% Or Greater Direct Ownership Interest Jan 1, 2016 100%
Corporate OfficerGoverning Board Member Jan 1, 2016 100%
Corporate DirectorGoverning Board Member Jan 1, 2016 100%
W-2 Managing EmployeeAlternate Administrator Jan 1, 2016 100%

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1497057632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 BEECH DALY",
            "address_2": "SUITE B",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251576",
            "telephone_number": "313-633-0765",
            "fax_number": "313-633-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 BEECH DALY",
            "address_2": "SUITE B",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251576",
            "telephone_number": "313-633-0765",
            "fax_number": "313-633-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC HOME HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "PERVEZ",
        "authorized_official_first_name": "TARIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-633-0765"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.