Provider Demographics
NPI:1811937428
Name:FAMILY HEARING CARE, LLC
Entity type:Organization
Organization Name:FAMILY HEARING CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:R
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:262-338-3553
Mailing Address - Street 1:1305 CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095
Mailing Address - Country:US
Mailing Address - Phone:262-338-3553
Mailing Address - Fax:262-338-3836
Practice Address - Street 1:1305 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095
Practice Address - Country:US
Practice Address - Phone:262-338-3553
Practice Address - Fax:262-338-3836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
WI6-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41173700Medicaid
WI41112700Medicaid
WI41173700Medicaid
WICARE PROVIDER #00018Medicare UPIN