Organization
FAMILY ADULT SITTING SERVICES, (FASS),LLC
Active
Other names
FASS
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE N WOULLARD (CEO)
(850) 358-6175
Entity
Organization
Contact information
Practice address
112 HENDERSON AVE, PANAMA CITY, FL 32401
(850) 358-6175
Mailing address
2319 S HIGHWAY 77 UNIT 1824, LYNN HAVEN, FL 32444-7773
(850) 358-6175
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
04/30/2021
Last updated
07/29/2022
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