MEDICARE: FAMILY OVER ALL, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1164169702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY OVER ALL, LLC

Provider Business Mailing Address
First Line	:	11 UNION ST S STE 314
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-5059
Country	:	US
Telephone Number	:	704-960-4097
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 UNION ST S STE 314
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-5059
Country	:	US
Telephone Number	:	704-960-4097
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	ALISSA C HOWARD
Credential	:	BSN, RN
Telephone Number	:	704-264-6841

Provider Enumeration Date	:	05/16/2022
Last Update Date	:	05/16/2022

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