Provider Demographics
NPI:1790466043
Name:BD HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:BD HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:AL HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-278-3173
Mailing Address - Street 1:11048 MARSHA PL
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-1038
Mailing Address - Country:US
Mailing Address - Phone:929-278-3173
Mailing Address - Fax:
Practice Address - Street 1:11048 MARSHA PL
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-1038
Practice Address - Country:US
Practice Address - Phone:929-278-3173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health