Provider Demographics
NPI:1356087399
Name:FAMILY PRIVATE HOME CARE, LLC
Entity Type:Organization
Organization Name:FAMILY PRIVATE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-620-3064
Mailing Address - Street 1:1905 WOODSTOCK RD STE 5200
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5630
Mailing Address - Country:US
Mailing Address - Phone:678-620-3064
Mailing Address - Fax:
Practice Address - Street 1:1905 WOODSTOCK RD STE 5200
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-5630
Practice Address - Country:US
Practice Address - Phone:678-620-3064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care