# FAMILY CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689745069
- **Authorized official:** MR. HANNA C ILLA MD (OWNER)
- **Authorized official phone:** (615) 666-6425

## Contact information

- **Practice address:** 207 WEST LOCUST STREET, LAFAYETTE, TN 37083
- **Practice address phone:** (615) 666-6425
- **Practice address fax:** (615) 666-3261
- **Mailing address:** 207 WEST LOCUST STREET, LAFAYETTE, TN 37083
- **Mailing address phone:** (615) 666-6425
- **Mailing address fax:** (615) 666-3261

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD30470 | TN | Yes |

## Other

- **Enumeration date:** 11/10/2006
- **Last updated:** 08/22/2020