Healthcare Provider Details
I. General information
NPI: 1386848661
Provider Name (Legal Business Name): FIRST STEP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2007
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 OWINGS CT SUITE 8
REISTERSTOWN MD
21136-6428
US
IV. Provider business mailing address
10400 RIDGLAND RD SUITE 1
COCKEYSVILLE MD
21030-2715
US
V. Phone/Fax
- Phone: 410-526-7100
- Fax:
- Phone: 410-628-6120
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | 904255 |
| License Number State | MD |
VIII. Authorized Official
Name: MS.
KIMBERLY
BITTINGER
Title or Position: BUSINESS OPERATIONS MANAGER
Credential:
Phone: 410-628-6120