Provider Demographics
NPI:1588028385
Name:FAMILY FIRST STAFFING AGENCY
Entity Type:Organization
Organization Name:FAMILY FIRST STAFFING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHYKINA
Authorized Official - Middle Name:TYEISHA
Authorized Official - Last Name:BARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:321-917-1066
Mailing Address - Street 1:1811 N COCOA BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-6939
Mailing Address - Country:US
Mailing Address - Phone:321-917-1066
Mailing Address - Fax:
Practice Address - Street 1:1811 N COCOA BLVD STE B
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-6939
Practice Address - Country:US
Practice Address - Phone:321-917-1066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL16000053720251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health