Healthcare Provider Details

I. General information

NPI: 1235492661
Provider Name (Legal Business Name): FIRST FOOT FORWARD FAMILY SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SANFORD ST
WEST HAVEN CT
06516-2351
US

IV. Provider business mailing address

PO BOX 3316
NEW HAVEN CT
06515-0416
US

V. Phone/Fax

Practice location:
  • Phone: 203-936-8516
  • Fax:
Mailing address:
  • Phone: 203-936-8516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: MR. ULISH BOOKER
Title or Position: MEMBER
Credential:
Phone: 517-803-5481