Provider Demographics
NPI:1578011078
Name:OUR FAMILY HOME HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:OUR FAMILY HOME HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDARILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-765-5061
Mailing Address - Street 1:PO BOX 2106
Mailing Address - Street 2:
Mailing Address - City:FABENS
Mailing Address - State:TX
Mailing Address - Zip Code:79838-2106
Mailing Address - Country:US
Mailing Address - Phone:915-765-5061
Mailing Address - Fax:915-765-5061
Practice Address - Street 1:1268 TWIG ST
Practice Address - Street 2:
Practice Address - City:FABENS
Practice Address - State:TX
Practice Address - Zip Code:79838
Practice Address - Country:US
Practice Address - Phone:915-765-5061
Practice Address - Fax:915-765-5061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health