Provider Demographics
NPI:1710679246
Name:FAMILY FIRST HOMECARE, LLC
Entity Type:Organization
Organization Name:FAMILY FIRST HOMECARE, LLC
Other - Org Name:FAMILY FIRST HOMECARE OF FORT LAUDERDALE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-850-0042
Mailing Address - Street 1:2203 N LOIS AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-2387
Mailing Address - Country:US
Mailing Address - Phone:813-850-0042
Mailing Address - Fax:813-850-0043
Practice Address - Street 1:4901 NW 17TH WAY STE 402
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3778
Practice Address - Country:US
Practice Address - Phone:954-820-6077
Practice Address - Fax:954-820-6078
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY FIRST HOMECARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-23
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health