Provider Demographics
NPI:1992403000
Name:AMERICAN FAMILY SYSTEM LLC
Entity type:Organization
Organization Name:AMERICAN FAMILY SYSTEM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN JOSE
Authorized Official - Middle Name:ENOWKPEN
Authorized Official - Last Name:AYUKETAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-882-5753
Mailing Address - Street 1:7632 OVERGLEN DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-9338
Mailing Address - Country:US
Mailing Address - Phone:513-882-5753
Mailing Address - Fax:
Practice Address - Street 1:7632 OVERGLEN DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-9338
Practice Address - Country:US
Practice Address - Phone:513-882-5753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health