Provider Demographics
NPI:1275231706
Name:FURAHA CARE HOMES LLC
Entity Type:Organization
Organization Name:FURAHA CARE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-814-0498
Mailing Address - Street 1:44157 W COPPER TRL
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-5426
Mailing Address - Country:US
Mailing Address - Phone:520-582-0367
Mailing Address - Fax:
Practice Address - Street 1:44157 W COPPER TRL
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85139-5426
Practice Address - Country:US
Practice Address - Phone:520-582-0367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ154773Medicaid