Provider Demographics
NPI:1770320921
Name:FAFALISHOUSE HOME CARE LLC
Entity type:Organization
Organization Name:FAFALISHOUSE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-221-7236
Mailing Address - Street 1:3809 LANCOVE WAY
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34981-4704
Mailing Address - Country:US
Mailing Address - Phone:754-221-7236
Mailing Address - Fax:
Practice Address - Street 1:3809 LANCOVE WAY
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34981-4704
Practice Address - Country:US
Practice Address - Phone:754-221-7236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care