Provider Demographics
NPI:1639487317
Name:FAMILY HOME HEALTH CARE OF FAIRFIELD COUNTY LLC
Entity Type:Organization
Organization Name:FAMILY HOME HEALTH CARE OF FAIRFIELD COUNTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-856-3201
Mailing Address - Street 1:11 WINTHROP AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5814
Mailing Address - Country:US
Mailing Address - Phone:203-856-3201
Mailing Address - Fax:
Practice Address - Street 1:191 POST RD W
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4625
Practice Address - Country:US
Practice Address - Phone:203-856-3201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health