Provider Demographics
NPI:1871679738
Name:FAMILY HOME CARE, INC.
Entity Type:Organization
Organization Name:FAMILY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CALTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-938-0081
Mailing Address - Street 1:PO BOX 1690
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-1690
Mailing Address - Country:US
Mailing Address - Phone:919-938-0081
Mailing Address - Fax:919-938-0083
Practice Address - Street 1:1680 E BOOKER DAIRY ROAD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-9405
Practice Address - Country:US
Practice Address - Phone:919-938-0081
Practice Address - Fax:919-938-0083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2469251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601040Medicaid