Provider Demographics
NPI:1619550597
Name:FAMILY FIRST CARE REGISTRY
Entity Type:Organization
Organization Name:FAMILY FIRST CARE REGISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-937-9277
Mailing Address - Street 1:416 S 39TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1621
Mailing Address - Country:US
Mailing Address - Phone:402-269-0671
Mailing Address - Fax:
Practice Address - Street 1:416 S 39TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1621
Practice Address - Country:US
Practice Address - Phone:402-269-0671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health