Provider Demographics
NPI:1699498832
Name:FAMILY LIFE HOME HEALTH CARE
Entity type:Organization
Organization Name:FAMILY LIFE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-221-9982
Mailing Address - Street 1:4030 MOUNT CARMEL TOBASCO RD STE 113
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3431
Mailing Address - Country:US
Mailing Address - Phone:513-221-9982
Mailing Address - Fax:513-528-0126
Practice Address - Street 1:4030 MOUNT CARMEL TOBASCO RD STE 113
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3431
Practice Address - Country:US
Practice Address - Phone:513-221-9982
Practice Address - Fax:513-528-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health