Provider Demographics
NPI:1265585137
Name:OUR FAMILY HOME CARE
Entity type:Organization
Organization Name:OUR FAMILY HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ETHEL
Authorized Official - Middle Name:ANITA
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-658-4260
Mailing Address - Street 1:201 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2129
Mailing Address - Country:US
Mailing Address - Phone:210-657-4260
Mailing Address - Fax:210-658-9475
Practice Address - Street 1:201 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2129
Practice Address - Country:US
Practice Address - Phone:210-657-4260
Practice Address - Fax:210-658-9475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116853310400000X
TX116196320800000X
TX115950320800000X
TX119176251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness