Provider Demographics
NPI:1841804937
Name:FRIENDS2FAMILY HOME CARE SUPPORT LLC
Entity Type:Organization
Organization Name:FRIENDS2FAMILY HOME CARE SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BETHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-932-8365
Mailing Address - Street 1:10005 MILL CENTRE DR APT 272
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3015
Mailing Address - Country:US
Mailing Address - Phone:443-932-8365
Mailing Address - Fax:
Practice Address - Street 1:10005 MILL CENTRE DR APT 272
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3015
Practice Address - Country:US
Practice Address - Phone:443-932-8365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care