Provider Demographics
NPI:1831689777
Name:A FATHERS' LOVE FAMILY CARE INC
Entity type:Organization
Organization Name:A FATHERS' LOVE FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELINE
Authorized Official - Middle Name:GRANTHOM
Authorized Official - Last Name:MCINIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-288-4020
Mailing Address - Street 1:709 PRINCE AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530
Mailing Address - Country:US
Mailing Address - Phone:919-288-4020
Mailing Address - Fax:
Practice Address - Street 1:213 N. CAROLINA ST.
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530
Practice Address - Country:US
Practice Address - Phone:919-288-4020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health