Providers Home Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROVIDERS HOME CARE, LLC

Practice address

14650 W Warren Ave Ste 250
Dearborn, MI 48126-1700

Phone

(313) 274-8710

Fax

(313) 274-8711

NPI assigned

Oct 1, 2007

Last updated

Dec 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yahia Shukr

Title

Administrator

Phone

(313) 274-8710

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790972123. Details of each certification follow.

• CCN 237771 Home health agency · Active · Details

Home health agency certification: CCN 237771

Legal name

PROVIDERS HOME CARE, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 6, 2008

Last certification

Oct 6, 2008

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

14650 W Warren Ave
Ste 250
Dearborn, MI 48126-1700
HHA Branch

Listed as

Providers Home CareCCN 237771 · All quality measures

Overall star rating

4.5 of 5

Ownership

Proprietary

Certified

Oct 6, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

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

Affiliated clinicians 6

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

• Hussein Hassan Ajrouche, MD

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1073675427

  Home health agency

  Care Compare affiliation
• Alex Bouhachem, DPM

  • Foot & Ankle Surgery Podiatrist
  • Dearborn, MI
  • NPI 1912905340

  Home health agency

  Care Compare affiliation
• Hussein Fadl Darwiche

  • Orthopaedic Surgery Physician
  • Detroit, MI
  • NPI 1457528283

  Home health agency

  Care Compare affiliation
• Mohammad Sobhi Elmenini, M.D.

  • Family Medicine Physician
  • Dearborn, MI
  • NPI 1821042581

  Home health agency

  Care Compare affiliation
• Iman Fakih-Elmenini, M.D.

  • Internal Medicine Physician
  • Dearborn Heights, MI
  • NPI 1841242989

  Home health agency

  Care Compare affiliation
• Tarif Hussein Mustafa Sr., MD

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1902870470

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1790972123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14650 W WARREN AVE STE 250",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261700",
            "telephone_number": "313-274-8710",
            "fax_number": "313-274-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 W WARREN AVE STE 250",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261700",
            "telephone_number": "313-274-8710",
            "fax_number": "313-274-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDERS HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "SHUKR",
        "authorized_official_first_name": "YAHIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-274-8710"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Professional Home Doctors (Eastborn Medical Clinci)
• Professional Physical Therapy Clinic Inc
• Progressive Recovery LLC
• Matthew Proudfoot, D.O.
• Seraphina Provenzano, DPT
• Providers Tek Inc.
• Dasheika Jatone Provost
• Cynthia A Pruett, LMSW
• Valerie Przywara, LLP
• Psychology Talk

• Home Health Agency in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.