# PROVIDERS HOME CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790972123
- **Authorized official:** YAHIA SHUKR (ADMINISTRATOR)
- **Authorized official phone:** (313) 274-8710

## Contact information

- **Practice address:** 14650 W WARREN AVE STE 250, DEARBORN, MI 48126-1700
- **Practice address phone:** (313) 274-8710
- **Practice address fax:** (313) 274-8711
- **Mailing address:** 14650 W WARREN AVE STE 250, DEARBORN, MI 48126-1700
- **Mailing address phone:** (313) 274-8710
- **Mailing address fax:** (313) 274-8711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | MI | Yes |
| 251E00000X | Home Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 10/01/2007
- **Last updated:** 12/19/2023