Provider Demographics
NPI:1558320218
Name:A FAMILIAR FACE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:A FAMILIAR FACE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:N
Authorized Official - Last Name:VENTURA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:941-365-9474
Mailing Address - Street 1:3222 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-8902
Mailing Address - Country:US
Mailing Address - Phone:941-365-9474
Mailing Address - Fax:941-365-1963
Practice Address - Street 1:3222 17TH ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-8902
Practice Address - Country:US
Practice Address - Phone:941-365-9474
Practice Address - Fax:941-365-1963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA22025096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107639Medicare ID - Type UnspecifiedHOME HEALTH PROVIDER NO.
FL107639Medicare Oscar/Certification