Healthcare Provider Details

I. General information

NPI: 1952898413
Provider Name (Legal Business Name): FAMILY TO FAMILY ADULT CARE SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2018
Last Update Date: 11/15/2025
Certification Date: 11/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 MONROE AVE
MEMPHIS TN
38104-3736
US

IV. Provider business mailing address

1503 MONROE AVE
MEMPHIS TN
38104-3736
US

V. Phone/Fax

Practice location:
  • Phone: 901-209-5549
  • Fax: 901-209-5549
Mailing address:
  • Phone: 901-209-5549
  • Fax: 901-209-5549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateTN

VIII. Authorized Official

Name: THEA R HERNDON
Title or Position: CEO
Credential:
Phone: 901-209-5549