MEDICARE: FAMILY HOME CARE ONE, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1245713346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HOME CARE ONE, LLC

Provider Business Mailing Address
First Line	:	3923 LAKE WORTH RD STE 213
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-4049
Country	:	US
Telephone Number	:	561-318-5460
Fax Number	:

Provider Business Practice Location Address
First Line	:	3923 LAKE WORTH RD STE 213
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-4049
Country	:	US
Telephone Number	:	561-318-5460
Fax Number	:	561-328-3703

Authorized Official
Title or Position	:	OWNER/ ADMINISTRATOR
Name	:	BARBARA VOLCY
Credential	:
Telephone Number	:	561-506-3509

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	09/13/2018

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