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General NPI Number Information
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NPI Number | 1336768811
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Entity Type | Organization
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Legal Business Name | A FAMILY FRIEND LLC
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 702 N PERSON ST
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City | RALEIGH
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State | NC
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Zip | 27604-1216
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Country | US
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Telephone | 919-626-4917
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Fax |
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Provider Business Mailing Address
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Address Line | 4133 BAY RUM LN
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City | RALEIGH
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State | NC
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Zip | 27610-6333
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Country | US
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Telephone | 919-626-4917
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Fax |
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Authorized Official
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Title or Position | CEO/ FOUNDER
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Name | KIMBLE BREAZELL
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Credential |
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Telephone | 919-626-4917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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