NPIMap

Organization Active NPI

Family Life Care, Inc.

  • Home Health Agency
  • Live Oak, FL
National Provider Identifier
1750934659
Registry record updated Jul 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
FAMILY LIFE CARE, INC.
Practice address
406 Ohio Ave S
Live Oak, FL 32064-3218
Phone
(386) 364-5515
Fax
(386) 364-5648
NPI assigned
Jul 19, 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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Clinical Social Worker 1041C0700X
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

406 Ohio Ave S
Live Oak, FL 32064-3218

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
299992645OtherFLHOME HEALTH AGENCY LICENSE
009916900MedicaidFL

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": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1750934659",
    "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": "406 OHIO AVE S",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320643218",
            "telephone_number": "386-364-5515",
            "fax_number": "386-364-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LIFE CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY LIFE CARE, INC.",
        "enumeration_date": "2019-07-19",
        "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": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AGENCY LICENSE",
            "identifier": "299992645",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009916900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, 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.