Provider Demographics
NPI:1174677082
Name:FAMILY CARE HOME HEALTH & HOSPICE, LLC
Entity Type:Organization
Organization Name:FAMILY CARE HOME HEALTH & HOSPICE, LLC
Other - Org Name:FAMILY CARE HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SISON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:702-882-1861
Mailing Address - Street 1:1640 E SAHARA AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3490
Mailing Address - Country:US
Mailing Address - Phone:702-650-9366
Mailing Address - Fax:702-650-9388
Practice Address - Street 1:1640 E SAHARA AVE
Practice Address - Street 2:SUITE E
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3490
Practice Address - Country:US
Practice Address - Phone:702-650-9366
Practice Address - Fax:702-650-9388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4111HHA-6251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health