NPI Code Details Logo

NPI 1578085460

NPI 1578085460 : FAMILY CARE AT HOME LLC : BROOKLYN, NY

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1578085460
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    FAMILY CARE AT HOME LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/12/2017
-----------------------------------------------------
    Last Update Date     |    07/21/2022
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    5121 2ND AVE 
-----------------------------------------------------
    City                 |    BROOKLYN
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    11232-2629
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    718-395-3710
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    5121 2ND AVE 
-----------------------------------------------------
    City                 |    BROOKLYN
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    11232-2629
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    718-395-3710
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    EXECUTIVE PRESIDENT
-----------------------------------------------------
    Name                 |     SHEBAZ  ALI 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    347-324-0128
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

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