Provider Demographics
NPI:1891765723
Name:FAMILY HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:FAMILY HOME HEALTH CARE LLC
Other - Org Name:AMEDISYS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUSSEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:3854 AMERICAN WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4013
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:937 CAMPBELLSVILLE RD
Practice Address - Street 2:SUITE 903
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-2265
Practice Address - Country:US
Practice Address - Phone:270-384-6411
Practice Address - Fax:270-384-3928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150108251B00000X, 251E00000X, 251S00000X
KY105129251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY45344280Medicaid
KY111571OtherCAREMARK INC PROVIDER ID
KY7100162920Medicaid
KY7100162950Medicaid
KY1059740OtherPASSPORT PROVIDER ID
KY34004010Medicaid
KY7100162880Medicaid
KY42010017Medicaid
KY7100162960Medicaid
KY1166978OtherCHA HEALTH PROVIDER ID
KY000000054994OtherBLUE CROSS PROVIDER ID
KY41100033Medicaid
KY1059740OtherPASSPORT PROVIDER ID
KY=========009OtherTRICARE EPS KYCASEY ID
KY=========011OtherTRICARE EPS KYCUMBERLAND
KY42010017Medicaid
KY45344280Medicaid
KY41100033Medicaid
KY000000054994OtherBLUE CROSS PROVIDER ID
KY1166978OtherCHA HEALTH PROVIDER ID
KY=========007OtherTRICARE EPS KYADAIR ID
KY=========010OtherTRICARE EPS KYCLINTON ID
KY42010017Medicaid