Provider Demographics
NPI:1689114019
Name:ONE FAMILY HOME HEALTH CARE
Entity Type:Organization
Organization Name:ONE FAMILY HOME HEALTH CARE
Other - Org Name:ONE FAMILY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:ERLYNE
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-631-0432
Mailing Address - Street 1:19 BURNING WICK PL
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8802
Mailing Address - Country:US
Mailing Address - Phone:386-631-0432
Mailing Address - Fax:386-597-2779
Practice Address - Street 1:19 BURNING WICK PL
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8802
Practice Address - Country:US
Practice Address - Phone:386-631-0432
Practice Address - Fax:386-597-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-04
Last Update Date:2017-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906826311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home