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General NPI Number Information
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NPI Number | 1003128984
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Entity Type | Organization
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Legal Business Name | FIRST CARE
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Dates
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Enumeration Date | 07/08/2010
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Last Update Date | 07/08/2010
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Provider Practice Location Address
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Address Line | 506 W MARION AVE SUITE H
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City | CRYSTAL SPRINGS
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State | MS
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Zip | 39059-2711
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Country | US
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Telephone | 601-892-7350
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Fax | 601-892-7351
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Provider Business Mailing Address
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Address Line | 506 W MARION AVE
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City | CRYSTAL SPRINGS
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State | MS
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Zip | 39059-2711
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Country | US
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Telephone | 601-892-7350
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Fax | 601-892-7351
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | MISS LACARINGTON DOMINIQUE LAWRENCE
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Credential | CNA
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Telephone | 601-892-7350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | AO62588
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License Number State | MS
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