Provider Demographics
NPI:1790756013
Name:FAMILY HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:FAMILY HOME HEALTH CARE INC
Other - Org Name:CASEY COUNTY ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF ADMINISTRATIVE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-219-3939
Mailing Address - Street 1:39 HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:KY
Mailing Address - Zip Code:42539
Mailing Address - Country:US
Mailing Address - Phone:606-787-0488
Mailing Address - Fax:606-787-5940
Practice Address - Street 1:39 HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:42539
Practice Address - Country:US
Practice Address - Phone:606-787-0488
Practice Address - Fax:606-787-5940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY750102261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY43010230Medicaid