=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568754398
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY FRIENDS HOMEMAKER COMPANION SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2011
-----------------------------------------------------
Last Update Date | 05/12/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5331 COMMERCIAL WAY SUITE 211
-----------------------------------------------------
City | SPRING HILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34606-1449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-835-7195
-----------------------------------------------------
Fax | 352-835-7197
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5331 COMMERCIAL WAY SUITE 211
-----------------------------------------------------
City | SPRING HILL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34606-1449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-835-7195
-----------------------------------------------------
Fax | 352-835-7197
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. RHODA CRANDALL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 352-650-9997
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | 232001
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------