Provider Demographics
NPI:1952898413
Name:FAMILY TO FAMILY ADULT CARE SERVICE
Entity type:Organization
Organization Name:FAMILY TO FAMILY ADULT CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THEA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HERNDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-209-5549
Mailing Address - Street 1:1503 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3736
Mailing Address - Country:US
Mailing Address - Phone:901-209-5549
Mailing Address - Fax:901-209-5549
Practice Address - Street 1:1503 MONROE AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3736
Practice Address - Country:US
Practice Address - Phone:901-209-5549
Practice Address - Fax:901-209-5549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
385H00000X, 251G00000X, 253Z00000X, 311500000X, 374U00000X, 376J00000X
TN372500000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)Group - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemaker