MEDICARE: PHOENIX HOME HEALTH CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1477544823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	34 35TH ST STE 4-5B516
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-2021
Country	:	US
Telephone Number	:	248-824-6000
Fax Number	:	855-618-6655

Provider Business Practice Location Address
First Line	:	500 KIRTS BLVD
Second Line	:	STE 270
City	:	TROY
State	:	MI
Zip	:	48084-4135
Country	:	US
Telephone Number	:	248-591-0265
Fax Number	:	248-591-0260

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID ALBERT
Credential	:
Telephone Number	:	718-748-5908

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	08/19/2025

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