Provider Demographics
NPI:1811553779
Name:FAMILY AND FAITH HOME CARE, LLC
Entity Type:Organization
Organization Name:FAMILY AND FAITH HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORT/IT/ACCOUNTING/HR
Authorized Official - Prefix:
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-453-2200
Mailing Address - Street 1:130 E WASHINGTON AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-3668
Mailing Address - Country:US
Mailing Address - Phone:423-453-2200
Mailing Address - Fax:423-453-2223
Practice Address - Street 1:130 E WASHINGTON AVE STE 4
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3668
Practice Address - Country:US
Practice Address - Phone:423-453-2200
Practice Address - Fax:423-453-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1386106664OtherTYPE 1 NPI
TNQ048565Medicaid
TNL000000024212OtherPERSONAL SUPPORT AGENCY