NPIMap

Organization Active NPI

Family Life Care, Inc.

  • In Home Supportive Care Agency
  • Gainesville, FL
National Provider Identifier
1114915295
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
4061 NW 43Rd St Ste 10
Gainesville, FL 32606-4538
Phone
(352) 692-2899
Fax
(352) 374-4409
NPI assigned
Oct 12, 2005
Last updated
Jul 20, 2020By the provider in NPPES
Organization subpart
No

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 NU Primary

Addresses

Primary practice location

4061 NW 43Rd St Ste 10
Gainesville, FL 32606-4538

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
009653800MedicaidFL
30211029OtherFLNURSE REGISTRY

National Provider Directory

National Provider Directory

Locations

4061 NW 43rd St
Ste 10
Gainesville, FL 32606
Phone (352) 692-2899

104 Howard St E
Live Oak, FL 32064

Ownership & related parties

Subparts reporting this organization as parent 5

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1114915295",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 NW 43RD ST STE 10",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326064538",
            "telephone_number": "352-692-2899",
            "fax_number": "352-374-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LIFE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009653800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE REGISTRY",
            "identifier": "30211029",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, 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.