Provider Demographics
NPI:1821144544
Name:A FRIENDLY HOME HEALTH CARE LLC.
Entity Type:Organization
Organization Name:A FRIENDLY HOME HEALTH CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:ANI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOPALAKRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-248-8282
Mailing Address - Street 1:100 N CENTAL EXPRESSWAY SUITE 190
Mailing Address - Street 2:ROOM 112
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:972-248-8282
Mailing Address - Fax:972-248-9077
Practice Address - Street 1:100 N CENTRAL EXPRESSWAY SUITE 190
Practice Address - Street 2:ROOM 112
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-248-8282
Practice Address - Fax:972-248-9077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017231251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677875Medicare UPIN