Provider Demographics
NPI:1063199719
Name:PRO HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:PRO HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONI
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-224-1777
Mailing Address - Street 1:48671 PIONEER AVE
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-5559
Mailing Address - Country:US
Mailing Address - Phone:586-339-8439
Mailing Address - Fax:
Practice Address - Street 1:48671 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-5559
Practice Address - Country:US
Practice Address - Phone:586-339-8439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health