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General NPI Number Information
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NPI Number | 1225750359
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Entity Type | Organization
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Legal Business Name | FIRST CARE 101K LLC
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 204 LOUIS CARTER RD
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City | HARRISVILLE
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State | MS
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Zip | 39082-4117
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Country | US
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Telephone | 601-858-2056
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Fax |
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Provider Business Mailing Address
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Address Line | 204 LOUIS CARTER RD
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City | HARRISVILLE
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State | MS
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Zip | 39082-4117
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Country | US
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Telephone | 601-858-2056
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SHIRLEY ANN SMITH
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Credential |
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Telephone | 601-858-2056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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