Provider Demographics
NPI:1124787338
Name:FAMILYWORKS HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:FAMILYWORKS HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEDRICK
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:CLEVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-998-1885
Mailing Address - Street 1:1833 CHEDDAR LOOP APT 504
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-4007
Mailing Address - Country:US
Mailing Address - Phone:512-998-1885
Mailing Address - Fax:512-519-2220
Practice Address - Street 1:1833 CHEDDAR LOOP APT 504
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-4007
Practice Address - Country:US
Practice Address - Phone:512-998-1885
Practice Address - Fax:512-519-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care