Provider Demographics
NPI:1366797227
Name:OUR FAMILY HEALTHCARE, LLC
Entity type:Organization
Organization Name:OUR FAMILY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LONNY
Authorized Official - Middle Name:
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:800-829-4933
Mailing Address - Street 1:485 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE 357
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-3987
Mailing Address - Country:US
Mailing Address - Phone:800-829-4933
Mailing Address - Fax:
Practice Address - Street 1:485 E FOOTHILL BLVD
Practice Address - Street 2:SUITE 357
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3987
Practice Address - Country:US
Practice Address - Phone:800-829-4933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service