Provider Demographics
NPI:1598523953
Name:FAMILY DIRECT HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:FAMILY DIRECT HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:AKAROLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-398-4893
Mailing Address - Street 1:2481 HURT RD SW STE F
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-6029
Mailing Address - Country:US
Mailing Address - Phone:177-086-3078
Mailing Address - Fax:
Practice Address - Street 1:2481 HURT RD SW STE F
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-6029
Practice Address - Country:US
Practice Address - Phone:177-086-3078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health