=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295156024
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIRST STEP DEVELOPMENT GROUP, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2013
-----------------------------------------------------
Last Update Date | 03/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 455 NE 5TH AVE STE D-304
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33483-5661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-372-0072
-----------------------------------------------------
Fax | 888-704-2232
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 455 NE 5TH AVE STE D-304
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33483-5661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-372-0027
-----------------------------------------------------
Fax | 888-704-2232
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | ELIZA SALERNO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 800-372-0072
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 146D00000X
-----------------------------------------------------
Taxonomy Name | Personal Emergency Response Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3747A0650X
-----------------------------------------------------
Taxonomy Name | Attendant Care Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 333300000X
-----------------------------------------------------
Taxonomy Name | Emergency Response System Companies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------