Provider Demographics
NPI:1124664305
Name:FAMILY CARE HOME HEALTH AND HOSPICE
Entity type:Organization
Organization Name:FAMILY CARE HOME HEALTH AND HOSPICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-299-5100
Mailing Address - Street 1:2440 ADOBE RD
Mailing Address - Street 2:STE 106
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-4485
Mailing Address - Country:US
Mailing Address - Phone:928-299-5100
Mailing Address - Fax:928-299-5026
Practice Address - Street 1:713 N BEAVER ST STE 1
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3142
Practice Address - Country:US
Practice Address - Phone:928-299-5100
Practice Address - Fax:928-299-5026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY CARE HOME HEALTH AND HOSPICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-21
Last Update Date:2024-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health