Provider Demographics
NPI:1437515608
Name:FAMILY FIRST HOME CARE
Entity Type:Organization
Organization Name:FAMILY FIRST HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:HOME CARE SPECIALIST
Authorized Official - Phone:601-493-3004
Mailing Address - Street 1:1 RUBY LN
Mailing Address - Street 2:PO BOX 18452
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-8022
Mailing Address - Country:US
Mailing Address - Phone:601-304-1194
Mailing Address - Fax:
Practice Address - Street 1:1 RUBY LN
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-8022
Practice Address - Country:US
Practice Address - Phone:601-304-1194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health