Provider Demographics
NPI:1811529084
Name:FAMILY AFFAIR HOME CARE, INC.
Entity type:Organization
Organization Name:FAMILY AFFAIR HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:CEO/ADMINASTRATOR
Authorized Official - Phone:267-970-6775
Mailing Address - Street 1:1401 N 5TH ST APT 219
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-3666
Mailing Address - Country:US
Mailing Address - Phone:267-970-6775
Mailing Address - Fax:
Practice Address - Street 1:4219 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-2923
Practice Address - Country:US
Practice Address - Phone:215-687-7559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty