Provider Demographics
NPI:1720556574
Name:FAMILY TIES HOME HEALTH LLC
Entity Type:Organization
Organization Name:FAMILY TIES HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KWANESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-990-7874
Mailing Address - Street 1:667 NOAH AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-3759
Mailing Address - Country:US
Mailing Address - Phone:330-990-7874
Mailing Address - Fax:
Practice Address - Street 1:1416 SEWARD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-3337
Practice Address - Country:US
Practice Address - Phone:330-990-7874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health