Provider Demographics
NPI:1093576001
Name:A FAMILIAR FACE HOME CARE LLC
Entity Type:Organization
Organization Name:A FAMILIAR FACE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-480-6800
Mailing Address - Street 1:8640 E WASHINGTON ST STE B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-6853
Mailing Address - Country:US
Mailing Address - Phone:317-480-6800
Mailing Address - Fax:
Practice Address - Street 1:8640 E WASHINGTON ST STE B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-6853
Practice Address - Country:US
Practice Address - Phone:317-480-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty