Provider Demographics
NPI:1477682573
Name:FAMILY CARE HOME INC
Entity Type:Organization
Organization Name:FAMILY CARE HOME INC
Other - Org Name:ARDEN FAMILY CARE HOME 2
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILBUR
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-259-3898
Mailing Address - Street 1:PO BOX 8129
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28814-8129
Mailing Address - Country:US
Mailing Address - Phone:828-259-3898
Mailing Address - Fax:828-259-3927
Practice Address - Street 1:82 BRADLEY BRANCH RD
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8315
Practice Address - Country:US
Practice Address - Phone:828-259-3898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL 011 203310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7805344Medicaid