1538467956 NPI number — A FAMILY MEMBER HOMECARE HOLDINGS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538467956 NPI number — A FAMILY MEMBER HOMECARE HOLDINGS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A FAMILY MEMBER HOMECARE HOLDINGS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538467956
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2525 N STATE ROAD 7
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
HOLLYWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33021-3201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-986-5090
Provider Business Mailing Address Fax Number:
954-986-5091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2525 N STATE ROAD 7
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-986-5090
Provider Business Practice Location Address Fax Number:
954-986-5091
Provider Enumeration Date:
03/09/2011

Additional Information

Authorized Official

Authorized Official Last Name:
VELASQUEZ
Authorized Official First Name:
VERONICA
Authorized Official Middle Name:
Authorized Official Title or Position:
OPERATIONS MANAGER
Authorized Official Telephone Number:
954-986-5090

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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