Healthcare Provider Details

I. General information

NPI: 1205375862
Provider Name (Legal Business Name): U-FIRST HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2017
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4228 1ST AVE STE 1
TUCKER GA
30084-4426
US

IV. Provider business mailing address

4228 1ST AVE STE 1
TUCKER GA
30084-4426
US

V. Phone/Fax

Practice location:
  • Phone: 833-583-4778
  • Fax: 833-583-4779
Mailing address:
  • Phone: 833-583-4778
  • Fax: 833-583-4779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. DOROTHY DELISFORT-CRISOSTOMO
Title or Position: OWNER
Credential:
Phone: 833-583-4778