Provider Demographics
NPI:1093080707
Name:HEALTHFIRST FAMILY CARE CENTER, INC.
Entity Type:Organization
Organization Name:HEALTHFIRST FAMILY CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-934-0177
Mailing Address - Street 1:841 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03235-2026
Mailing Address - Country:US
Mailing Address - Phone:603-934-0177
Mailing Address - Fax:603-934-2805
Practice Address - Street 1:22 STRAFFORD ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-4701
Practice Address - Country:US
Practice Address - Phone:603-366-1070
Practice Address - Fax:603-366-1071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30211899Medicaid