Provider Demographics
NPI:1073668778
Name:FAMILY HOMECARE SERVICES INC
Entity Type:Organization
Organization Name:FAMILY HOMECARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TEGA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-272-7098
Mailing Address - Street 1:215 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:PEACHLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28133
Mailing Address - Country:US
Mailing Address - Phone:704-272-7098
Mailing Address - Fax:704-272-7068
Practice Address - Street 1:215 SCHOOL ST
Practice Address - Street 2:C
Practice Address - City:PEACHLAND
Practice Address - State:NC
Practice Address - Zip Code:28133
Practice Address - Country:US
Practice Address - Phone:704-272-7098
Practice Address - Fax:704-272-7068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC35174251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418252Medicaid
NC6601613Medicaid