Provider Demographics
NPI:1043422066
Name:FAMILY HOME HEALTH CARE SERVICES INC
Entity Type:Organization
Organization Name:FAMILY HOME HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:KNOLL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSPA
Authorized Official - Phone:989-773-5546
Mailing Address - Street 1:2266 ENTERPRISE DR STE 3
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2344
Mailing Address - Country:US
Mailing Address - Phone:989-773-5546
Mailing Address - Fax:989-779-0113
Practice Address - Street 1:2266 ENTERPRISE DR STE 3
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2344
Practice Address - Country:US
Practice Address - Phone:989-773-5546
Practice Address - Fax:989-779-0113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704145101251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI204Medicaid