MEDICARE: FAMILY HOME HEALTH CARE, INC.

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	008615	TX

General Provider Information

NPI Number	:	1689762387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	3220 NORTH FWY
Second Line	:	STE. 106
City	:	FORT WORTH
State	:	TX
Zip	:	76111-1827
Country	:	US
Telephone Number	:	817-589-0055
Fax Number	:	817-589-0075

Provider Business Practice Location Address
First Line	:	3220 NORTH FWY
Second Line	:	STE. 106
City	:	FORT WORTH
State	:	TX
Zip	:	76111-1827
Country	:	US
Telephone Number	:	817-589-0055
Fax Number	:	817-589-0075

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SHARON CLARK
Credential	:
Telephone Number	:	817-589-0055

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	08/22/2020

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