Provider Demographics
NPI:1891311148
Name:HEBRON FAMILY CARE HOME LLC
Entity Type:Organization
Organization Name:HEBRON FAMILY CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-216-8376
Mailing Address - Street 1:1310 HEBRON RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-5181
Mailing Address - Country:US
Mailing Address - Phone:828-216-8376
Mailing Address - Fax:828-434-9360
Practice Address - Street 1:1310 HEBRON RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-5181
Practice Address - Country:US
Practice Address - Phone:828-216-8376
Practice Address - Fax:828-434-9360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home