Provider Demographics
NPI:1922272996
Name:FAMILY FIRST HEALTH CENTER
Entity Type:Organization
Organization Name:FAMILY FIRST HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:DELICIA
Authorized Official - Middle Name:MONE'
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-492-1064
Mailing Address - Street 1:788 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-1428
Mailing Address - Country:US
Mailing Address - Phone:502-608-4340
Mailing Address - Fax:
Practice Address - Street 1:1898 S CLYDE MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32119-1579
Practice Address - Country:US
Practice Address - Phone:386-492-1064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care