MEDICARE: FAMILY CARE HOME HEALTH & HOSPICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1316609324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE HOME HEALTH & HOSPICE

Provider Business Mailing Address
First Line	:	1695 MESQUITE AVE STE 108
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5684
Country	:	US
Telephone Number	:	928-302-3338
Fax Number	:

Provider Business Practice Location Address
First Line	:	1695 MESQUITE AVE STE 108
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5684
Country	:	US
Telephone Number	:	928-302-3338
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MOHAMMED AHMED
Credential	:	MD
Telephone Number	:	928-299-5100

Provider Enumeration Date	:	10/07/2021
Last Update Date	:	05/26/2024

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Directions to “FAMILY CARE HOME HEALTH & HOSPICE ” Practice Location

Language	Start Address	Practice Location

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