Provider Demographics
NPI:1588325310
Name:FAMILY CARE WELLNESS LLC
Entity type:Organization
Organization Name:FAMILY CARE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLANKENSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:931-474-4000
Mailing Address - Street 1:207 OAK PARK
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-1336
Mailing Address - Country:US
Mailing Address - Phone:931-474-4000
Mailing Address - Fax:931-474-4701
Practice Address - Street 1:207 OAK PARK
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1336
Practice Address - Country:US
Practice Address - Phone:931-474-4700
Practice Address - Fax:931-474-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN104100000XMedicaid
TN261QR13OOXMedicaid
TN363L00000XMedicaid