Provider Demographics
NPI:1962642595
Name:FA HO LO FAMILY INC
Entity Type:Organization
Organization Name:FA HO LO FAMILY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SEEWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-557-8308
Mailing Address - Street 1:PO BOX 209
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-0209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:231-788-5698
Practice Address - Street 1:1585 S WOLF LAKE RD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-4881
Practice Address - Country:US
Practice Address - Phone:231-788-1806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAM610009197320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities