03D2135068 CLIA NUMBER - FAMILY CARE HOME HEALTH & HOSPICE

Laboratory Demographics

CLIA Number: 03D2135068

Facility Name: FAMILY CARE HOME HEALTH & HOSPICE

Facility Address:
2580 HWY 95 STE 203
BULLHEAD CITY, AZ
ZIP 86442
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Facility Phone Number: (928) 299-5100

Facility Type: HOME HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1124664305

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Field Name	Field Value
CLIA Number	03D2135068
LAB Type	HOME HEALTH AGENCY
Facility Name	FAMILY CARE HOME HEALTH & HOSPICE
Street	2580 HWY 95 STE 203
City	BULLHEAD CITY
State	AZ
ZIP	86442
Phone	(928) 299-5100

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Laboratory Demographics

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