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General NPI Number Information
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NPI Number | 1790573020
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Entity Type | Organization
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Legal Business Name | OUR FAMILY HOME CARE, LLC
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 5964 58TH ST S
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City | FARGO
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State | ND
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Zip | 58104-5680
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Country | US
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Telephone | 701-318-9023
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Fax |
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Provider Business Mailing Address
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Address Line | 5964 58TH ST S
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City | FARGO
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State | ND
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Zip | 58104-5680
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Country | US
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Telephone | 701-318-9023
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANGELINA ZENON
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Credential |
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Telephone | 701-318-9023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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