Provider Demographics
NPI:1841961182
Name:FAMILY CARE HOSPICE INC
Entity type:Organization
Organization Name:FAMILY CARE HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JERAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TIBON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-805-7940
Mailing Address - Street 1:3420 E SHEA BLVD STE 200-250
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3345
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4700 S MILL AVE # B15
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6736
Practice Address - Country:US
Practice Address - Phone:602-805-7940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based