Provider Demographics
NPI:1750039541
Name:FHAE LLC
Entity Type:Organization
Organization Name:FHAE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-988-3403
Mailing Address - Street 1:145 VALLECITOS DE ORO STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-1458
Mailing Address - Country:US
Mailing Address - Phone:760-350-3200
Mailing Address - Fax:
Practice Address - Street 1:145 VALLECITOS DE ORO STE 205
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-1458
Practice Address - Country:US
Practice Address - Phone:619-988-3403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care