Provider Demographics
NPI:1053073452
Name:NSCN HOMECARE GROUP, LLC
Entity Type:Organization
Organization Name:NSCN HOMECARE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:EHTESHAM
Authorized Official - Middle Name:EDDIN
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-506-1996
Mailing Address - Street 1:48645 VAN DYKE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-2576
Mailing Address - Country:US
Mailing Address - Phone:248-274-6225
Mailing Address - Fax:
Practice Address - Street 1:48645 VAN DYKE AVE STE 201
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-2576
Practice Address - Country:US
Practice Address - Phone:248-274-6225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care