Provider Demographics
NPI:1982271375
Name:THE GOOD SHEPHERD HOME CARE AGENCY, INC.
Entity type:Organization
Organization Name:THE GOOD SHEPHERD HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZUHAIR
Authorized Official - Middle Name:N
Authorized Official - Last Name:FAKHOURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-554-8740
Mailing Address - Street 1:4147 METRO PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4520
Mailing Address - Country:US
Mailing Address - Phone:505-480-5984
Mailing Address - Fax:
Practice Address - Street 1:4147 METRO PKWY STE 105
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4520
Practice Address - Country:US
Practice Address - Phone:586-554-7840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-05
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251B00000XAgenciesCase Management
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care