Provider Demographics
NPI:1205616000
Name:FAMILY HOME CAREGIVER, LLC
Entity type:Organization
Organization Name:FAMILY HOME CAREGIVER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABASSUM
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-469-6552
Mailing Address - Street 1:10 DUANE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4202
Mailing Address - Country:US
Mailing Address - Phone:347-469-6552
Mailing Address - Fax:484-893-2760
Practice Address - Street 1:650 N CANNON AVE STE 132
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1874
Practice Address - Country:US
Practice Address - Phone:347-469-6552
Practice Address - Fax:484-893-2760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health