Provider Demographics
NPI:1952986564
Name:FAMILY FIRST HOME CARE LLC
Entity Type:Organization
Organization Name:FAMILY FIRST HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEROSIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:986-224-9604
Mailing Address - Street 1:3494 N GRENADIER WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-2063
Mailing Address - Country:US
Mailing Address - Phone:986-224-9604
Mailing Address - Fax:
Practice Address - Street 1:3494 N GRENADIER WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-2063
Practice Address - Country:US
Practice Address - Phone:986-224-9604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health