Healthcare Provider Details

I. General information

NPI: 1871147355
Provider Name (Legal Business Name): FAMILY FIRST THERAPUETIC STAFFING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 08/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 SE FEDERAL HWY 220
STUART FL
34994-4556
US

IV. Provider business mailing address

2400 SE FEDERAL HWY 220
STUART FL
34994-4556
US

V. Phone/Fax

Practice location:
  • Phone: 772-486-4870
  • Fax:
Mailing address:
  • Phone: 772-486-4870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JONATHAN GARY PEIRCE
Title or Position: OWNER
Credential:
Phone: 772-486-4870