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General NPI Number Information
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NPI Number | 1285520874
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Entity Type | Organization
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Legal Business Name | FIRST CLASS HOME CARE LLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1847 TAYLOR AVE
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City | RACINE
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State | WI
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Zip | 53403-2477
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Country | US
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Telephone | 262-800-5009
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Fax |
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Provider Business Mailing Address
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Address Line | 1847 TAYLOR AVE
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City | RACINE
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State | WI
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Zip | 53403-2477
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Country | US
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Telephone | 262-800-5009
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Fax |
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Authorized Official
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Title or Position | OWNER / MANAGING MEMBER
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Name | MR. KEITH CLAY-TERRELL
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Credential |
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Telephone | 262-800-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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