Healthcare Provider Details
I. General information
NPI: 1285560151
Provider Name (Legal Business Name): FIRST STATE HOME PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24371 CALDWELL CIR
LEWES DE
19958-5396
US
IV. Provider business mailing address
24371 CALDWELL CIR
LEWES DE
19958-5396
US
V. Phone/Fax
- Phone: 856-979-1986
- Fax:
- Phone: 856-979-1986
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
HOWARD
R
TURETZKY
Title or Position: MEMBER
Credential:
Phone: 856-979-1986