Provider Demographics
NPI:1316609324
Name:FAMILY CARE HOME HEALTH & HOSPICE
Entity type:Organization
Organization Name:FAMILY CARE HOME HEALTH & 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 1:1695 MESQUITE AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5684
Mailing Address - Country:US
Mailing Address - Phone:928-302-3338
Mailing Address - Fax:
Practice Address - Street 1:1695 MESQUITE AVE STE 108
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5684
Practice Address - Country:US
Practice Address - Phone:928-302-3338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2024-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based