Provider Demographics
NPI:1891252755
Name:FAMILY FIRST CARE LLC
Entity Type:Organization
Organization Name:FAMILY FIRST CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:267-239-2259
Mailing Address - Street 1:3939 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-3423
Mailing Address - Country:US
Mailing Address - Phone:267-239-2259
Mailing Address - Fax:267-239-2103
Practice Address - Street 1:3939 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-3423
Practice Address - Country:US
Practice Address - Phone:267-239-2259
Practice Address - Fax:267-239-2103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1034686220001Medicaid