Provider Demographics
NPI:1649523911
Name:FAMILY CARE HOME HEALTH & HOSPICE, LLC
Entity type:Organization
Organization Name:FAMILY CARE HOME HEALTH & HOSPICE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-834-6900
Mailing Address - Street 1:6960 OBANNON DR
Mailing Address - Street 2:SUITE 190
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2850
Mailing Address - Country:US
Mailing Address - Phone:702-834-6900
Mailing Address - Fax:702-834-7188
Practice Address - Street 1:6960 OBANNON DR
Practice Address - Street 2:SUITE 190
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2850
Practice Address - Country:US
Practice Address - Phone:702-834-6900
Practice Address - Fax:702-834-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVS7445PCA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNVS7445PCAOtherNEVADA BUREAU OF HEALTH CARE QUALITY AND COMPLIANCE