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General NPI Number Information
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NPI Number | 1093576001
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Entity Type | Organization
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Legal Business Name | A FAMILIAR FACE HOME CARE LLC
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 2426 55TH PL
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-3502
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Country | US
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Telephone | 463-221-2605
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Fax | 463-221-2507
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Provider Business Mailing Address
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Address Line | 8640 E WASHINGTON ST STE B
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-6853
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Country | US
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Telephone | 317-480-6800
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | SASHA ODOM
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Credential |
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Telephone | 317-480-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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