Provider Demographics
NPI:1710659883
Name:FAMILY BOND IN-HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:FAMILY BOND IN-HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-708-1815
Mailing Address - Street 1:10122 E 4TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74128-1222
Mailing Address - Country:US
Mailing Address - Phone:405-708-1815
Mailing Address - Fax:
Practice Address - Street 1:10122 E 4TH PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74128-1222
Practice Address - Country:US
Practice Address - Phone:405-708-1815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care