Provider Demographics
NPI:1811664493
Name:FAMILY HOME CARE PROVIDER LLC
Entity type:Organization
Organization Name:FAMILY HOME CARE PROVIDER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ABDIHAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-414-9331
Mailing Address - Street 1:3536 CARLIN SPRINGS RD STE 10N
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3035
Mailing Address - Country:US
Mailing Address - Phone:571-414-9331
Mailing Address - Fax:
Practice Address - Street 1:3536 CARLIN SPRINGS RD STE 10N
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3035
Practice Address - Country:US
Practice Address - Phone:571-414-9331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health