Healthcare Provider Details

I. General information

NPI: 1003365800
Provider Name (Legal Business Name): FAMILY FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 HOOD ROAD SUITE 100
PALM BEACH GARDENS FL
33418-8910
US

IV. Provider business mailing address

5220 HOOD ROAD SUITE 100
PALM BEACH GARDENS FL
33418-8910
US

V. Phone/Fax

Practice location:
  • Phone: 561-328-7370
  • Fax:
Mailing address:
  • Phone: 561-328-7370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY G SCHWABE
Title or Position: ACCOUNT MANAGER
Credential: MSHSA, LHRM
Phone: 512-900-3363