Provider Demographics
NPI:1275697211
Name:FAMILY HOMES INC
Entity Type:Organization
Organization Name:FAMILY HOMES INC
Other - Org Name:BYRON ICF DDH HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HERMIE
Authorized Official - Middle Name:V
Authorized Official - Last Name:YEMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-757-7725
Mailing Address - Street 1:865 ALTA LOMA DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-2159
Mailing Address - Country:US
Mailing Address - Phone:650-757-7725
Mailing Address - Fax:650-757-7232
Practice Address - Street 1:70 MONTEREY DR
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-3862
Practice Address - Country:US
Practice Address - Phone:650-991-3926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC60652GOtherLTC NUMBER