Healthcare Provider Details

I. General information

NPI: 1134055635
Provider Name (Legal Business Name): SALAM BOUSSI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23711 ROCKFORD ST
DEARBORN MI
48124-1624
US

IV. Provider business mailing address

23711 ROCKFORD ST
DEARBORN MI
48124-1624
US

V. Phone/Fax

Practice location:
  • Phone: 313-247-1441
  • Fax:
Mailing address:
  • Phone: 313-247-1441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: