Provider Demographics
NPI:1821696451
Name:FAMILY CARE HOME HEALTH AND HOSPICE UT LLC
Entity Type:Organization
Organization Name:FAMILY CARE HOME HEALTH AND HOSPICE UT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-445-1354
Mailing Address - Street 1:169 W 2710 SOUTH CIR STE 202A
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7205
Mailing Address - Country:US
Mailing Address - Phone:435-767-9346
Mailing Address - Fax:
Practice Address - Street 1:315 W HILTON DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2319
Practice Address - Country:US
Practice Address - Phone:435-767-9346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health