Provider Demographics
NPI:1336768811
Name:A FAMILY FRIEND LLC
Entity type:Organization
Organization Name:A FAMILY FRIEND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BREAZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-626-4917
Mailing Address - Street 1:4133 BAY RUM LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-6333
Mailing Address - Country:US
Mailing Address - Phone:919-626-4917
Mailing Address - Fax:
Practice Address - Street 1:702 N PERSON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1216
Practice Address - Country:US
Practice Address - Phone:919-626-4917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty