=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245022979
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HABIBA HOME CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2025
-----------------------------------------------------
Last Update Date | 05/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24328 AUDREY AVE
-----------------------------------------------------
City | WARREN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48091-1774
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-303-6660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24328 AUDREY AVE
-----------------------------------------------------
City | WARREN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48091-1774
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-303-6660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KAMRUL ISLAM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 313-303-6660
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------