Provider Demographics
NPI:1760752885
Name:FAMILY FIRST OF OHIO LLC
Entity Type:Organization
Organization Name:FAMILY FIRST OF OHIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:AFRICALYNN
Authorized Official - Last Name:DRAPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-577-1891
Mailing Address - Street 1:838 BROOKLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-3156
Mailing Address - Country:US
Mailing Address - Phone:678-577-1891
Mailing Address - Fax:419-536-2110
Practice Address - Street 1:4312 FOXCHAPEL RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-2110
Practice Address - Country:US
Practice Address - Phone:678-577-1891
Practice Address - Fax:419-536-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4806062253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0058582Medicaid