Provider Demographics
NPI:1720841752
Name:FAMILY WELL HOME CARE
Entity Type:Organization
Organization Name:FAMILY WELL HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KAFUBA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-860-9669
Mailing Address - Street 1:2801 WEATHERSTONE CIR SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-2080
Mailing Address - Country:US
Mailing Address - Phone:678-860-9669
Mailing Address - Fax:877-804-2638
Practice Address - Street 1:2801 WEATHERSTONE CIR SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-2080
Practice Address - Country:US
Practice Address - Phone:678-860-9669
Practice Address - Fax:877-804-2638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care