Provider Demographics
NPI:1568432433
Name:FAMILY HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:FAMILY HOME HEALTH CARE LLC
Other - Org Name:AMEDISYS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUSSEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:3854 AMERICAN WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4013
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:2480 FORTUNE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-4178
Practice Address - Country:US
Practice Address - Phone:859-271-0611
Practice Address - Fax:859-271-0751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150170251B00000X, 251E00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000054994OtherBLUE CROSS PROVIDER ID
KY7100123960Medicaid
KY34000165Medicaid
KY42001065Medicaid
KY7100163030Medicaid
KY45344280Medicaid
KY7100163000Medicaid
KY34001065Medicaid
KY62182368014OtherTRICARE EPS KYMADISON
KY=========006OtherTRICARE EPS KYBULLITT ID
KY7100163000Medicaid
KY=========017OtherTRICARE EPS KYLINCOLN
KY45344280Medicaid
KY34000165Medicaid
KY34000165Medicaid