Healthcare Provider Details

I. General information

NPI: 1659852432
Provider Name (Legal Business Name): FAMILY FIRST SENIOR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N ARGONNE RD STE B103
SPOKANE VALLEY WA
99212-2867
US

IV. Provider business mailing address

521 N ARGONNE RD STE B103
SPOKANE VALLEY WA
99212-2867
US

V. Phone/Fax

Practice location:
  • Phone: 509-326-5525
  • Fax:
Mailing address:
  • Phone: 509-326-5525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: JENNIPHER AMA
Title or Position: PRESIDENT
Credential: RN, CMC
Phone: 509-326-5525