Provider Demographics
NPI:1801201652
Name:FAMILY HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:FAMILY HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAKA
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-933-2223
Mailing Address - Street 1:5653 COLUMBIA PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-2873
Mailing Address - Country:US
Mailing Address - Phone:703-933-2223
Mailing Address - Fax:703-933-8887
Practice Address - Street 1:5653 COLUMBIA PIKE STE 200
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-2873
Practice Address - Country:US
Practice Address - Phone:703-933-2223
Practice Address - Fax:703-933-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-14432251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1497941785Medicaid