Healthcare Provider Details

I. General information

NPI: 1326910258
Provider Name (Legal Business Name): HOUSE OF WELLNESS HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24225 W 9 MILE RD
SOUTHFIELD MI
48033-3962
US

IV. Provider business mailing address

24225 W 9 MILE RD STE 140
SOUTHFIELD MI
48033-3979
US

V. Phone/Fax

Practice location:
  • Phone: 586-220-6172
  • Fax:
Mailing address:
  • Phone: 586-220-6172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NUSABA MAGDI MAHGOUB
Title or Position: OWNER
Credential:
Phone: 313-778-2982