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General NPI Number Information
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NPI Number | 1174380349
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Entity Type | Organization
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Legal Business Name | FAMILYLIFEHOMECARE
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 17 N WILSON ST
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City | MUSKEGON
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State | MI
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Zip | 49442-1859
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Country | US
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Telephone | 231-888-2090
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Fax |
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Provider Business Mailing Address
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Address Line | 15576 W MONTECITO AVE
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City | GOODYEAR
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State | AZ
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Zip | 85395-7784
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Country | US
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Telephone | 623-980-0011
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAYLA MCGLORY
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Credential |
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Telephone | 231-888-2090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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