MEDICARE: FAMILY FIRST HOME HEALTH CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1174140180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FIRST HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	35 HARVARD ST
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02124-1994
Country	:	US
Telephone Number	:	857-615-3733
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 COLUMBUS AVE
Second Line	:
City	:	ROXBURY
State	:	MA
Zip	:	02119-1026
Country	:	US
Telephone Number	:	857-615-3733
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DEEQO JIBRIL
Credential	:
Telephone Number	:	857-615-3733

Provider Enumeration Date	:	06/25/2020
Last Update Date	:	06/25/2020

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Directions to “FAMILY FIRST HOME HEALTH CARE ” Practice Location

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