Healthcare Provider Details

I. General information

NPI: 1134565567
Provider Name (Legal Business Name): FAMILY FIRST CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 05/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 S WHITE HORSE PIKE
AUDUBON NJ
08106-1314
US

IV. Provider business mailing address

607 S WHITE HORSE PIKE
AUDUBON NJ
08106-1314
US

V. Phone/Fax

Practice location:
  • Phone: 856-672-0001
  • Fax: 856-672-0001
Mailing address:
  • Phone: 856-672-0001
  • Fax: 856-672-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL FIRETTO
Title or Position: OFFICE MANAGER
Credential:
Phone: 856-672-0001