Provider Demographics
NPI:1932699899
Name:A PART OF OUR FAMILY HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:A PART OF OUR FAMILY HOME CARE AGENCY LLC
Other - Org Name:HOME CARE FOR THE 21ST CENTURY- SE READING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GAVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-299-3170
Mailing Address - Street 1:203 TROY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-2885
Mailing Address - Country:US
Mailing Address - Phone:347-299-3170
Mailing Address - Fax:
Practice Address - Street 1:20 N FRONT ST
Practice Address - Street 2:
Practice Address - City:BALLY
Practice Address - State:PA
Practice Address - Zip Code:19503
Practice Address - Country:US
Practice Address - Phone:347-299-3170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care