Provider Demographics
NPI:1366856338
Name:FAMILY TIES HOME CARE, INC.
Entity Type:Organization
Organization Name:FAMILY TIES HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:TRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-208-6963
Mailing Address - Street 1:58 E GREENE ST
Mailing Address - Street 2:
Mailing Address - City:WAYNESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15370-1846
Mailing Address - Country:US
Mailing Address - Phone:724-852-1588
Mailing Address - Fax:
Practice Address - Street 1:58 E GREENE ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1846
Practice Address - Country:US
Practice Address - Phone:724-852-1588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25743601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care