# PRIMECARE RESIDENTIAL SUPPORT LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1871443648
- **Authorized official:** MARIAM GHANEM (OWNER)
- **Authorized official phone:** (734) 450-9953

## Contact information

- **Practice address:** 25433 AVONDALE ST, DEARBORN HEIGHTS, MI 48125-1001
- **Practice address phone:** (734) 450-9953
- **Mailing address:** 25433 AVONDALE ST, DEARBORN HEIGHTS, MI 48125-1001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2026
- **Last updated:** 02/02/2026