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Organization

FAMILY 1579 LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL BOOTH (OWNER)
(724) 464-4641
Entity
Organization

Contact information

Practice address
420 OAK ST, INDIANA, PA 15701-1934
(724) 464-4641
Mailing address
420 OAK ST, INDIANA, PA 15701-1934
(724) 464-4641

Taxonomy

Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary

Other

Enumeration date
03/09/2026
Last updated
03/09/2026
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