Healthcare Provider Details

I. General information

NPI: 1760188189
Provider Name (Legal Business Name): FAMILY AFFAIR HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 GRANT ST
MCKEESPORT PA
15132-4513
US

IV. Provider business mailing address

1515 GRANT ST
MCKEESPORT PA
15132-4513
US

V. Phone/Fax

Practice location:
  • Phone: 412-853-2208
  • Fax:
Mailing address:
  • Phone: 412-853-2208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier104087934-0001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: BRAYLON HARDY
Title or Position: OWNDER
Credential:
Phone: 412-853-2220