Provider Demographics
NPI:1295463834
Name:EPIC FAVOR HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:EPIC FAVOR HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:ROCHE
Authorized Official - Last Name:BARFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-386-4951
Mailing Address - Street 1:1572 RALSTON ST
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46406-2347
Mailing Address - Country:US
Mailing Address - Phone:219-752-5013
Mailing Address - Fax:
Practice Address - Street 1:1572 RALSTON ST
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46406-2347
Practice Address - Country:US
Practice Address - Phone:219-752-5013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health