Healthcare Provider Details

I. General information

NPI: 1063124469
Provider Name (Legal Business Name): FIRST STEPZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2022
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E 96TH ST STE 500
INDIANAPOLIS IN
46240-3760
US

IV. Provider business mailing address

450 E 96TH ST STE 500
INDIANAPOLIS IN
46240-3760
US

V. Phone/Fax

Practice location:
  • Phone: 317-938-6802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JUNIE DERY
Title or Position: OWNER/ GENERAL MANAGER
Credential:
Phone: 317-938-6802