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General NPI Number Information
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NPI Number | 1437515608
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST HOME CARE
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 01/04/2016
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Provider Practice Location Address
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Address Line | 1 RUBY LN
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City | NATCHEZ
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State | MS
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Zip | 39120-8022
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Country | US
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Telephone | 601-304-1194
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Fax |
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Provider Business Mailing Address
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Address Line | 1 RUBY LN PO BOX 18452
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City | NATCHEZ
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State | MS
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Zip | 39120-8022
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Country | US
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Telephone | 601-304-1194
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Fax |
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Authorized Official
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Title or Position | OWNER/SPECIALIST
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Name | MR. LEE MELVIN JACKSON JR.
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Credential | HOME CARE SPECIALIST
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Telephone | 601-493-3004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | MS
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