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General NPI Number Information
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NPI Number | 1194246413
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Entity Type | Organization
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Legal Business Name | FAMILIAR CHOICE HOME CARE INC
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 06/28/2017
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Provider Practice Location Address
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Address Line | 808 MAIN ST
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City | SCOTT CITY
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State | MO
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Zip | 63780-2020
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Country | US
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Telephone | 573-264-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 6054 STATE ROUTE 162
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City | GLEN CARBON
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State | IL
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Zip | 62034-1810
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Country | US
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Telephone | 573-521-6647
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN SCHNEIDER
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Credential |
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Telephone | 573-521-6647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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