NPI Code Details Logo

NPI 1447091814

NPI 1447091814 : FAMI HEALTH CARE LLC : TOLLESON, AZ

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1447091814
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    FAMI HEALTH CARE LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/01/2024
-----------------------------------------------------
    Last Update Date     |    06/03/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    8433 W ATLANTIS WAY 
-----------------------------------------------------
    City                 |    TOLLESON
-----------------------------------------------------
    State                |    AZ
-----------------------------------------------------
    Zip                  |    85353-5732
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    602-753-6352
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    8433 W ATLANTIS WAY 
-----------------------------------------------------
    City                 |    TOLLESON
-----------------------------------------------------
    State                |    AZ
-----------------------------------------------------
    Zip                  |    85353-5732
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    602-753-6352
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    ADMINISTRATOR
-----------------------------------------------------
    Name                 |     FATUMA  NAMUSISI 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    602-753-6352
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251S00000X
-----------------------------------------------------
    Taxonomy Name        |    Community/Behavioral Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.