1558020404 NPI number — WE ARE FAMILY HOME CARE INC.

Table of content: (NPI 1558020404)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558020404 NPI number — WE ARE FAMILY HOME CARE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WE ARE FAMILY HOME CARE INC.
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:
1558020404
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6408 PERSHING RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHERERVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46375-3461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-669-5730
Provider Business Mailing Address Fax Number:
855-449-1892

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6408 PERSHING RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHERERVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46375-3461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-669-5730
Provider Business Practice Location Address Fax Number:
855-449-1892
Provider Enumeration Date:
12/08/2021

Additional Information

Authorized Official

Authorized Official Last Name:
BASILE
Authorized Official First Name:
MONIKA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
219-669-5730

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 21-013630-1 . This is a "INDIANA STATE DEPARTMENT OF HEALTH" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com