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General NPI Number Information
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NPI Number | 1619784667
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Entity Type | Organization
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Legal Business Name | SUPPORTIVE SOLUTIONS HOME CARE LLC
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 23916 MICHIGAN AVE STE 160
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City | DEARBORN
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State | MI
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Zip | 48124-1833
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Country | US
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Telephone | 313-492-9877
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Fax |
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Provider Business Mailing Address
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Address Line | 835 MASON ST STE C116
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City | DEARBORN
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State | MI
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Zip | 48124-2222
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Country | US
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Telephone | 313-492-9877
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Fax |
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Authorized Official
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Title or Position | OPERATOR
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Name | ALI HUSSEIN BEYDOUN
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Credential |
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Telephone | 313-377-8221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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