Healthcare Provider Details

I. General information

NPI: 1437262177
Provider Name (Legal Business Name): FAMILY FIRST HEALTH CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 W BURNSIDE AVE SUITE C
CHUBBUCK ID
83202-2411
US

IV. Provider business mailing address

190 W BURNSIDE AVE SUITE C
CHUBBUCK ID
83202-2411
US

V. Phone/Fax

Practice location:
  • Phone: 208-238-0400
  • Fax: 208-238-0401
Mailing address:
  • Phone: 208-238-0400
  • Fax: 208-238-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SYLVIA RIFE
Title or Position: PARTNER
Credential: FNP
Phone: 208-238-0400