# VICKSBURG FAMILY HOME CARE,LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vicksburg Family Home Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396215984
- **Authorized official:** MR. TERRY L BARNES JR. (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (269) 475-5211

## Contact information

- **Practice address:** 706 W PRAIRIE ST, VICKSBURG, MI 49097-4909
- **Practice address phone:** (269) 475-5211
- **Practice address fax:** (269) 315-5100
- **Mailing address:** 706 W PRAIRIE ST, VICKSBURG, MI 49097
- **Mailing address phone:** (269) 475-5211
- **Mailing address fax:** (269) 315-5100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253J00000X | Foster Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 261QA0600X | Adult Day Care Clinic/Center | — | NULL | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 11/27/2018
- **Last updated:** 04/12/2024