Provider Demographics
NPI:1528562196
Name:FAMILY TIES HOME & COMMUNITY SUPPORTS, INC.
Entity Type:Organization
Organization Name:FAMILY TIES HOME & COMMUNITY SUPPORTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:RIDER
Authorized Official - Last Name:TRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-852-1588
Mailing Address - Street 1:201 CARMICHAELS PLZ
Mailing Address - Street 2:
Mailing Address - City:CARMICHAELS
Mailing Address - State:PA
Mailing Address - Zip Code:15320-9642
Mailing Address - Country:US
Mailing Address - Phone:724-852-1588
Mailing Address - Fax:724-627-7713
Practice Address - Street 1:201 CARMICHAELS PLZ
Practice Address - Street 2:
Practice Address - City:CARMICHAELS
Practice Address - State:PA
Practice Address - Zip Code:15320-9642
Practice Address - Country:US
Practice Address - Phone:724-852-1588
Practice Address - Fax:724-627-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care