Provider Demographics
NPI:1346856374
Name:FAMILY CARE HOME HEALTH & HOSPICE
Entity Type:Organization
Organization Name:FAMILY CARE HOME HEALTH & HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-445-1354
Mailing Address - Street 1:1695 MESQUITE AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5684
Mailing Address - Country:US
Mailing Address - Phone:928-302-3338
Mailing Address - Fax:
Practice Address - Street 1:1695 MESQUITE AVE STE 108
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5684
Practice Address - Country:US
Practice Address - Phone:928-302-3338
Practice Address - Fax:928-302-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health