Provider Demographics
NPI:1265845903
Name:AMERICAN FAMILLY HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:AMERICAN FAMILLY HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-252-4651
Mailing Address - Street 1:2058 INTEGRITY DR S
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2728
Mailing Address - Country:US
Mailing Address - Phone:614-252-4651
Mailing Address - Fax:888-511-0533
Practice Address - Street 1:2058 INTEGRITY DR S
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2728
Practice Address - Country:US
Practice Address - Phone:614-252-4651
Practice Address - Fax:888-511-0533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
OH251J00000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3148285Medicaid