MEDICARE: KELLY HOME CARE SERVICES, INC.

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	HC0055	NC
2	251E00000X	Home Health Agency	HC0246	NC
3	251E00000X	Home Health Agency	HC0054	NC
4	251E00000X	Home Health Agency	HC0056	NC
5	251E00000X	Home Health Agency	HCO-07312	VA
6	251E00000X	Home Health Agency	HCO-07291	VA
7	251E00000X	Home Health Agency	HCO-07145	VA
8	251E00000X	Home Health Agency	HCO-07142	VA
9	251E00000X	Home Health Agency	IS-355	WA
10	251E00000X	Home Health Agency	044-R-0003	GA
11	251E00000X	Home Health Agency	121-R-0022	GA
12	251E00000X	Home Health Agency	025-R-0009	GA
13	251E00000X	Home Health Agency	003064	TX
14	251E00000X	Home Health Agency	15-2036	OR
15	251E00000X	Home Health Agency	20609096	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	397122	OTHER	WA	ALTCEW BR.6282 SPOKANE
3	112182	OTHER	OR	KAISER PERMANENTE
4	009213	OTHER	CA	SCAN BR.1481 PASADENA
5	3133	OTHER	VA	CITY OF VA BEACH-LOCAL CO
6	013531	OTHER	CA	SCAN BR.1585 ORANGE CO.
7	015027	OTHER	CA	SCAN BR.1497 CULVER
8	11489	OTHER	PA	CUMBERLAND CO, BR.5180
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831249432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KELLY HOME CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	999 W BIG BEAVER RD
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-4716
Country	:	US
Telephone Number	:	248-362-4444
Fax Number	:	248-244-5247

Provider Business Practice Location Address
First Line	:	999 W BIG BEAVER RD
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-4716
Country	:	US
Telephone Number	:	248-362-4444
Fax Number	:	248-244-5247

Authorized Official
Title or Position	:	BUSINESS UNIT LEADER
Name	:	MRS. MICHELLE (SHELLE) R WOMBLE
Credential	:
Telephone Number	:	248-244-4917

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	09/11/2025

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