Organization
PRIMECARE RESIDENTIAL SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAM GHANEM (OWNER)
(734) 450-9953
Entity
Organization
Contact information
Practice address
25433 AVONDALE ST, DEARBORN HEIGHTS, MI 48125-1001
(734) 450-9953
Mailing address
25433 AVONDALE ST, DEARBORN HEIGHTS, MI 48125-1001
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/02/2026
Last updated
02/02/2026
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