Healthcare Provider Details

I. General information

NPI: 1790389302
Provider Name (Legal Business Name): FAMILY FIRST HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 E BROADWAY AVE STE 2
BISMARCK ND
58501-4740
US

IV. Provider business mailing address

1906 E BROADWAY AVE STE 2
BISMARCK ND
58501-4740
US

V. Phone/Fax

Practice location:
  • Phone: 701-659-9256
  • Fax:
Mailing address:
  • Phone: 701-659-9256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: URSHELA YVONNE MORRIS
Title or Position: CEO
Credential:
Phone: 701-354-3355