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General NPI Number Information
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NPI Number | 1558798397
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST HEALTH CARE, INC.
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Dates
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Enumeration Date | 10/10/2013
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 1821 UNIVERSITY AVE W SUITE S-142
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City | SAINT PAUL
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State | MN
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Zip | 55104-2801
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Country | US
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Telephone | 651-917-5519
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Fax |
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Provider Business Mailing Address
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Address Line | 1821 UNIVERSITY AVE W SUITE S-142
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City | SAINT PAUL
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State | MN
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Zip | 55104-2801
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Country | US
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Telephone | 651-917-5519
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. PROSPER KOMLA DZAMESHIE
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Credential |
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Telephone | 651-917-5519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | MN
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