Organization
FAMILY FIRST HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRUDENCIA VOLLETIA HENDERSON (CEO)
(619) 371-2552
Entity
Organization
Contact information
Practice address
4225 EXECUTIVE SQ STE 600, LA JOLLA, CA 92037-1484
(619) 371-2552
Mailing address
4225 EXECUTIVE SQ STE 600, LA JOLLA, CA 92037-1484
(619) 371-2552
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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