Provider Demographics
NPI:1376250274
Name:FAMILY SUPPORT CARE LLC SKILLED
Entity Type:Organization
Organization Name:FAMILY SUPPORT CARE LLC SKILLED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CLEOPATRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-586-8249
Mailing Address - Street 1:3991 HAMILTON MIDDLETOWN RD STE I
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-6224
Mailing Address - Country:US
Mailing Address - Phone:513-795-7299
Mailing Address - Fax:513-795-6679
Practice Address - Street 1:3991 HAMILTON MIDDLETOWN RD STE I
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-6224
Practice Address - Country:US
Practice Address - Phone:513-795-7299
Practice Address - Fax:513-795-6679
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY SUPPORT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-31
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health