MEDICARE: FAMILY CARE HOME HEALTH & HOSPICE, 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	4111HHA	NV

General Provider Information

NPI Number	:	1871782342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CARE HOME HEALTH & HOSPICE, LLC

Provider Business Mailing Address
First Line	:	1945 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4583
Country	:	US
Telephone Number	:	702-650-9366
Fax Number	:	702-650-9388

Provider Business Practice Location Address
First Line	:	1945 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4583
Country	:	US
Telephone Number	:	702-650-9366
Fax Number	:	702-650-9388

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MOHAMMED AZIZUDDIN AHMED
Credential	:
Telephone Number	:	702-650-9366

Provider Enumeration Date	:	10/19/2007
Last Update Date	:	05/26/2024

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