Provider Demographics
NPI:1871016675
Name:FAMILY CARE HOME HEALTH & HOSPICE
Entity Type:Organization
Organization Name:FAMILY CARE HOME HEALTH & HOSPICE
Other - Org Name:FAMILY CARE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-299-5100
Mailing Address - Street 1:2580 HWAY 95 STE 201
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-7329
Mailing Address - Country:US
Mailing Address - Phone:928-299-5100
Mailing Address - Fax:928-299-5026
Practice Address - Street 1:2580 HWAY 95 STE 201
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7329
Practice Address - Country:US
Practice Address - Phone:928-299-5100
Practice Address - Fax:928-299-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
AZHSPC8446251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based