Provider Demographics
NPI:1922251370
Name:FAMILY INTENSIVE HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:FAMILY INTENSIVE HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAINT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:252-360-1807
Mailing Address - Street 1:602 SE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-1637
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:602 SE 3RD ST
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-1637
Practice Address - Country:US
Practice Address - Phone:252-360-1807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCN/A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health