MEDICARE: FIRST STEP PCA SERVICES LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1558249979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST STEP PCA SERVICES LLC

Provider Business Mailing Address
First Line	:	3221 CLINTON AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-3263
Country	:	US
Telephone Number	:	612-702-5104
Fax Number	:

Provider Business Practice Location Address
First Line	:	8427 KNOX AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55431-1760
Country	:	US
Telephone Number	:	507-319-6581
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABDIRISAK HIRSI
Credential	:
Telephone Number	:	612-702-5104

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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Directions to “FIRST STEP PCA SERVICES LLC ” Practice Location

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