Provider Demographics
NPI:1053834887
Name:FAMILY CARE HOME HEALTH & HOSPICE
Entity Type:Organization
Organization Name:FAMILY CARE HOME HEALTH & HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-299-5100
Mailing Address - Street 1:2580 HIGHWAY 95 STE 203
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-7329
Mailing Address - Country:US
Mailing Address - Phone:928-299-5100
Mailing Address - Fax:928-299-5026
Practice Address - Street 1:2580 HIGHWAY 95 STE 203
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7329
Practice Address - Country:US
Practice Address - Phone:928-299-5100
Practice Address - Fax:928-299-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health