Provider Demographics
NPI:1053204537
Name:CARESOURCE HOME HEALTH CARE
Entity type:Organization
Organization Name:CARESOURCE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMUD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-747-3940
Mailing Address - Street 1:4840 W CLARK RD
Mailing Address - Street 2:#215A
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197
Mailing Address - Country:US
Mailing Address - Phone:734-747-3940
Mailing Address - Fax:
Practice Address - Street 1:4840 W CLARK RD
Practice Address - Street 2:#215A
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197
Practice Address - Country:US
Practice Address - Phone:734-747-3940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health