Provider Demographics
NPI:1932953247
Name:FAMILY FIRST ADULT FOSTER CARE LLC
Entity Type:Organization
Organization Name:FAMILY FIRST ADULT FOSTER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BERUBE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:781-526-4377
Mailing Address - Street 1:52 BAKER RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-6710
Mailing Address - Country:US
Mailing Address - Phone:781-526-4377
Mailing Address - Fax:
Practice Address - Street 1:161 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-3817
Practice Address - Country:US
Practice Address - Phone:781-526-4377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty