Provider Demographics
NPI:1538514278
Name:FAMILY FIRST PERSONAL CARE
Entity Type:Organization
Organization Name:FAMILY FIRST PERSONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-395-1759
Mailing Address - Street 1:4501 NEW BERN AVE
Mailing Address - Street 2:STE 130-212
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1550
Mailing Address - Country:US
Mailing Address - Phone:301-395-1759
Mailing Address - Fax:
Practice Address - Street 1:4501 NEW BERN AVE
Practice Address - Street 2:STE 130-212
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1550
Practice Address - Country:US
Practice Address - Phone:301-395-1759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4469253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care