Provider Demographics
NPI:1013698893
Name:FAMILY 1ST OF VIRGINIA HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:FAMILY 1ST OF VIRGINIA HOME HEALTHCARE LLC
Other - Org Name:FAMILY 1ST HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GOUGH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:804-986-6431
Mailing Address - Street 1:1403 PEMBERTON RD STE 306
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23238-4474
Mailing Address - Country:US
Mailing Address - Phone:804-416-6831
Mailing Address - Fax:804-416-6823
Practice Address - Street 1:1403 PEMBERTON RD STE 306
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-4474
Practice Address - Country:US
Practice Address - Phone:804-416-6831
Practice Address - Fax:804-416-6823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty