Healthcare Provider Details

I. General information

NPI: 1699485672
Provider Name (Legal Business Name): FAMILY MATTERS COMMUNITY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 W BUCKEYE RD STE 105
PHOENIX AZ
85003-2648
US

IV. Provider business mailing address

7115 N 83RD AVE
GLENDALE AZ
85303-2332
US

V. Phone/Fax

Practice location:
  • Phone: 240-346-9712
  • Fax: 240-366-7076
Mailing address:
  • Phone: 240-346-9712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: WINNIE D MOORE
Title or Position: OWNER
Credential:
Phone: 240-346-9712