Provider Demographics
NPI:1982657292
Name:FAMILY HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:FAMILY HOME HEALTH SERVICES, INC.
Other - Org Name:FAMILY CENTERED HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEB
Authorized Official - Middle Name:
Authorized Official - Last Name:MUFFOLETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-317-3300
Mailing Address - Street 1:2171 W EXECUTIVE DR
Mailing Address - Street 2:SUITE 450
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-5610
Mailing Address - Country:US
Mailing Address - Phone:630-317-3300
Mailing Address - Fax:630-317-3310
Practice Address - Street 1:2171 W EXECUTIVE DR
Practice Address - Street 2:SUITE 450
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-5610
Practice Address - Country:US
Practice Address - Phone:630-317-3300
Practice Address - Fax:630-317-3310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2002442315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========002Medicaid
IL141622Medicare ID - Type Unspecified