NPIMap

Organization Active NPI

Family Life Care, Inc.

  • In Home Supportive Care Agency
  • Inverness, FL
National Provider Identifier
1174175509
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
216 S Apopka Ave Ste B
Inverness, FL 34452-4845
Phone
(352) 344-5228
Fax
(352) 344-0894
NPI assigned
Jul 16, 2019
Last updated
Jul 20, 2020By the provider in NPPES
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 NU Primary

Addresses

Primary practice location

216 S Apopka Ave Ste B
Inverness, FL 34452-4845

Mailing address

555 Wells Rd
Orange Park, FL 32073-2923
Phone (904) 579-1582

Other identifiers 2

IdentifierTypeStateIssuer
30211324OtherFLNURSE REGISTRY LICENSE
009971800MedicaidFL

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.

Locations

216 S Apopka Ave
Ste B
Inverness, FL 34452
Phone (352) 344-5228

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": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1174175509",
    "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": "904-579-1582",
            "fax_number": "904-375-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 S APOPKA AVE STE B",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524845",
            "telephone_number": "352-344-5228",
            "fax_number": "352-344-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LIFE CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY LIFE CARE, INC.",
        "enumeration_date": "2019-07-16",
        "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE REGISTRY LICENSE",
            "identifier": "30211324",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009971800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, 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.