Provider Demographics
NPI:1487995320
Name:FAMILY & FRIENDS HOME CARE, LLC
Entity type:Organization
Organization Name:FAMILY & FRIENDS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YYVETTE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-771-0739
Mailing Address - Street 1:2692 BRIER ST SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5205
Mailing Address - Country:US
Mailing Address - Phone:330-442-2840
Mailing Address - Fax:
Practice Address - Street 1:8031 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2200
Practice Address - Country:US
Practice Address - Phone:330-442-2840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN085609305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service