Provider Demographics
NPI:1285065839
Name:FAMILY 1ST HOME CARE LLC
Entity type:Organization
Organization Name:FAMILY 1ST HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER, LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:OCTAVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:828-390-8255
Mailing Address - Street 1:5401 S KIRKMAN RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7940
Mailing Address - Country:US
Mailing Address - Phone:321-200-7728
Mailing Address - Fax:
Practice Address - Street 1:5401 S KIRKMAN RD
Practice Address - Street 2:SUITE 310
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7940
Practice Address - Country:US
Practice Address - Phone:321-200-7728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health