NPIMap

Organization Active NPI

Family Life Care, Inc.

  • In Home Supportive Care Agency
  • Orange Park, FL
National Provider Identifier
1013569938
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
FAMILY LIFE CARE, INC.
Practice address
555 Wells Rd
Orange Park, FL 32073-2923
Phone
(904) 529-7072
NPI assigned
Jul 11, 2019
Organization subpart
Yes
Parent organization
FAMILY LIFE CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David McMullen
Title
Ceo
Phone
(904) 579-1581

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

555 Wells Rd
Orange Park, FL 32073-2923

Mailing address

555 Wells Rd
Orange Park, FL 32073-2923
Phone (904) 579-1581

Other identifiers 2

IdentifierTypeStateIssuer
687641200MedicaidFL
30211175OtherFLNURSE REGISTRY LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Family Life Care Inc5 organizations share this tax ID, including this one
Part of
Family Life Care Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1013569938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 WELLS RD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732923",
            "telephone_number": "904-579-1581",
            "fax_number": "904-375-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WELLS RD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732923",
            "telephone_number": "904-529-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LIFE CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY LIFE CARE, INC.",
        "enumeration_date": "2019-07-11",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "MCMULLEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-579-1581"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687641200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE REGISTRY LICENSE",
            "identifier": "30211175",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.