MEDICARE: FAMILY FOCUSED LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417098393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FOCUSED LLC.

Provider Business Mailing Address
First Line	:	PO BOX 12413
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-0119
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6235 MICHELAS BAY LN.
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-4468
Country	:	US
Telephone Number	:	910-313-0459
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. MICHELE DENISE MORSE
Credential	:	BS, QP
Telephone Number	:	910-313-0459

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	08/22/2020

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