MEDICARE: FAMILY FIRST CHILDREN SERVICES OF VIGINIA

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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427459114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FIRST CHILDREN SERVICES OF VIGINIA

Provider Business Mailing Address
First Line	:	PO BOX 35384
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-0384
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8012 MIDLOTHIAN TPKE
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-5232
Country	:	US
Telephone Number	:	804-560-5511
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	LISA MONROE
Credential	:
Telephone Number	:	804-560-5511

Provider Enumeration Date	:	09/12/2014
Last Update Date	:	01/14/2015

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