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FAMILY FIRST MEDICAL CENTER LLC NPI 1093070773


NPI Information

NPI: 1093070773
Provider Name: FAMILY FIRST MEDICAL CENTER LLC
Classification: Psychologist - 103TH0100X
Entity Type: Organization

Specialization: Health Service

Address:
1203 CLEVELAND AVE STE 1
EAST POINT, GA
ZIP 30344
Phone: (404) 209-1408
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FAMILY FIRST MEDICAL CENTER LLC is a health service psychologist in East Point, GA. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). FAMILY FIRST MEDICAL CENTER LLC NPI is 1093070773. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1203 CLEVELAND AVE STE 1
EAST POINT, GA
ZIP 30344-417
Phone: (404) 209-1408
Fax: (404) 209-1411

The provider's authorized official is Maria Pilar Moreira .
The authorized official title is Owner and has the following contact phone number (404) 209-1408.

The enumeration date for this NPI number is 7/9/2012 and was last updated on 7/9/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TH0100XPsychologistHealth Service08064086GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1511G700933MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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