Provider Demographics
NPI:1871026054
Name:FAMILY TIME CARE
Entity Type:Organization
Organization Name:FAMILY TIME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-707-0819
Mailing Address - Street 1:14374 MERCEDES
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3052
Mailing Address - Country:US
Mailing Address - Phone:248-707-0819
Mailing Address - Fax:313-472-5270
Practice Address - Street 1:14374 MERCEDES
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3052
Practice Address - Country:US
Practice Address - Phone:248-707-0819
Practice Address - Fax:313-472-5270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health