Provider Demographics
NPI:1245099803
Name:UNICARE HOME SERVICES LLC
Entity type:Organization
Organization Name:UNICARE HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOULAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-330-4527
Mailing Address - Street 1:1643 HOLMES RD # 2024
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-4155
Mailing Address - Country:US
Mailing Address - Phone:734-330-4527
Mailing Address - Fax:
Practice Address - Street 1:9800 LANCASTER DR
Practice Address - Street 2:
Practice Address - City:VAN BUREN TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48111-1664
Practice Address - Country:US
Practice Address - Phone:734-330-4527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care