Provider Demographics
NPI:1326354218
Name:FAMILY HOME CARE, INC.
Entity Type:Organization
Organization Name:FAMILY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:THOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:217-273-0593
Mailing Address - Street 1:80 BROADWAY AVE
Mailing Address - Street 2:102
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-4559
Mailing Address - Country:US
Mailing Address - Phone:217-235-0648
Mailing Address - Fax:217-235-3141
Practice Address - Street 1:80 BROADWAY AVE
Practice Address - Street 2:102
Practice Address - City:MATTOON
Practice Address - State:IL
Practice Address - Zip Code:61938-4559
Practice Address - Country:US
Practice Address - Phone:217-235-0648
Practice Address - Fax:217-235-3141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL67183339251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health