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General NPI Number Information
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NPI Number | 1760752885
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST OF OHIO LLC
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 4312 FOXCHAPEL RD
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City | TOLEDO
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State | OH
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Zip | 43607-2110
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Country | US
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Telephone | 678-577-1891
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Fax | 419-536-2110
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Provider Business Mailing Address
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Address Line | 838 BROOKLEY BLVD
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City | TOLEDO
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State | OH
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Zip | 43607-3156
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Country | US
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Telephone | 678-577-1891
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Fax | 419-536-2110
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MS. PATRICE AFRICALYNN DRAPER
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Credential |
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Telephone | 678-577-1891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 4806062
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License Number State | OH
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Legacy Identifiers
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Identifier #1
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Identifier Code | 0058582
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Identifier Type | MEDICAID
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Identifier State | OH
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 0058582
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Identifier Type | MEDICAID
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Identifier State | OH
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Identifier Issuer |
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