Provider Demographics
NPI:1346794120
Name:FAMILY HOME CARE, LLC
Entity Type:Organization
Organization Name:FAMILY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MILLSAP
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:601-323-7433
Mailing Address - Street 1:614 CHIPPEWAH DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39443-7413
Mailing Address - Country:US
Mailing Address - Phone:601-323-7433
Mailing Address - Fax:
Practice Address - Street 1:309 BAY ST
Practice Address - Street 2:
Practice Address - City:HEIDELBERG
Practice Address - State:MS
Practice Address - Zip Code:39439-3547
Practice Address - Country:US
Practice Address - Phone:601-323-7433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251E00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251E00000XAgenciesHome Health