MEDICARE: FIRST FAMILY HOMES L.L.C.

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		MI

General Provider Information

NPI Number	:	1942468137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST FAMILY HOMES L.L.C.

Provider Business Mailing Address
First Line	:	11000 W MCNICHOLS RD
Second Line	:	SUITE 102
City	:	DETROIT
State	:	MI
Zip	:	48221-2357
Country	:	US
Telephone Number	:	313-310-5732
Fax Number	:

Provider Business Practice Location Address
First Line	:	11000 W MCNICHOLS RD
Second Line	:	SUITE 102
City	:	DETROIT
State	:	MI
Zip	:	48221-2357
Country	:	US
Telephone Number	:	313-310-5732
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM ADMINISTRATOR
Name	:	CYNTHIA REYNOLDS
Credential	:	LMSW
Telephone Number	:	313-310-5732

Provider Enumeration Date	:	05/25/2008
Last Update Date	:	05/25/2008

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