Healthcare Provider Details

I. General information

NPI: 1114670924
Provider Name (Legal Business Name): FAMILY CARE & HOUSING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 N BENTALOU ST
BALTIMORE MD
21223-1417
US

IV. Provider business mailing address

511 N EDGEWOOD ST
BALTIMORE MD
21229-3060
US

V. Phone/Fax

Practice location:
  • Phone: 443-977-0964
  • Fax:
Mailing address:
  • Phone: 410-934-2236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TIFFANY L MACK
Title or Position: PRESIDENT
Credential: RN
Phone: 410-934-2236