Provider Demographics
NPI:1720227424
Name:FAMILY HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:FAMILY HOME CARE SERVICES, LLC
Other - Org Name:COMPASSIONATE HOMECARE, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HABERBOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MPH
Authorized Official - Phone:865-327-2077
Mailing Address - Street 1:9050 EXECUTIVE PARK DRIVE
Mailing Address - Street 2:SUITE A-102
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4669
Mailing Address - Country:US
Mailing Address - Phone:865-327-2077
Mailing Address - Fax:865-722-7171
Practice Address - Street 1:9050 EXECUTIVE PARK DRIVE
Practice Address - Street 2:SUITE A-102
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4669
Practice Address - Country:US
Practice Address - Phone:865-327-2077
Practice Address - Fax:865-722-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL000000003674253Z00000X
253Z00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445189OtherMEDICAID WAIVER
TNH445189Medicaid