Healthcare Provider Details

I. General information

NPI: 1194642710
Provider Name (Legal Business Name): FIRST STEP CARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 W COLONIAL DR STE 726
OCOEE FL
34761-6811
US

IV. Provider business mailing address

PO BOX 464
PLYMOUTH FL
32768-0464
US

V. Phone/Fax

Practice location:
  • Phone: 689-308-3232
  • Fax:
Mailing address:
  • Phone: 407-470-5908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SLYVING BOURDEAU
Title or Position: OWNER
Credential: LCSW
Phone: 407-470-5908