Provider Demographics
NPI:1912146739
Name:FAMILY HOMECARE INC
Entity Type:Organization
Organization Name:FAMILY HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLLSCHLEGER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:216-520-3700
Mailing Address - Street 1:6180 HALLE DR
Mailing Address - Street 2:UNIT A
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-4635
Mailing Address - Country:US
Mailing Address - Phone:216-520-3700
Mailing Address - Fax:216-520-3706
Practice Address - Street 1:6180 HALLE DR
Practice Address - Street 2:UNIT A
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-4635
Practice Address - Country:US
Practice Address - Phone:216-520-3700
Practice Address - Fax:216-520-3706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1819086332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2934570Medicaid
OH6262670002Medicare NSC