Provider Demographics
NPI:1518756402
Name:SELAM HOME CARE
Entity type:Organization
Organization Name:SELAM HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:UKUBAKEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-900-7729
Mailing Address - Street 1:2972 CORAL VALLEY DR SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-1849
Mailing Address - Country:US
Mailing Address - Phone:616-900-7729
Mailing Address - Fax:
Practice Address - Street 1:2972 CORAL VALLEY DR SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512-1849
Practice Address - Country:US
Practice Address - Phone:616-900-7729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health