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General NPI Number Information
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NPI Number | 1346794120
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Entity Type | Organization
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Legal Business Name | FAMILY HOME CARE, LLC
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Dates
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Enumeration Date | 08/09/2016
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | 309 BAY ST
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City | HEIDELBERG
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State | MS
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Zip | 39439-3547
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Country | US
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Telephone | 601-323-7433
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Fax |
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Provider Business Mailing Address
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Address Line | 614 CHIPPEWAH DR
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City | LAUREL
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State | MS
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Zip | 39443-7413
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Country | US
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Telephone | 601-323-7433
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICHELE ELIZABETH MILLSAP
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Credential | R.N.
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Telephone | 601-323-7433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | MS
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