Provider Demographics
NPI:1639617350
Name:FAMILY FIRST HOME HEALTHCARE ,LLC
Entity Type:Organization
Organization Name:FAMILY FIRST HOME HEALTHCARE ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONISHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-803-7406
Mailing Address - Street 1:506 S INDEPENDENCE BLVD
Mailing Address - Street 2:202
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1154
Mailing Address - Country:US
Mailing Address - Phone:757-502-4626
Mailing Address - Fax:
Practice Address - Street 1:506 S INDEPENDENCE BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1154
Practice Address - Country:US
Practice Address - Phone:757-803-7406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA156974-7200251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA156974-7200Medicaid