MEDICARE: FIRST CLASS HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1285520874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CLASS HOME CARE LLC

Provider Business Mailing Address
First Line	:	1847 TAYLOR AVE
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53403-2477
Country	:	US
Telephone Number	:	262-800-5009
Fax Number	:

Provider Business Practice Location Address
First Line	:	1847 TAYLOR AVE
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53403-2477
Country	:	US
Telephone Number	:	262-800-5009
Fax Number	:

Authorized Official
Title or Position	:	OWNER / MANAGING MEMBER
Name	:	MR. KEITH CLAY-TERRELL
Credential	:
Telephone Number	:	262-800-5009

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	06/18/2025

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Directions to “FIRST CLASS HOME CARE LLC ” Practice Location

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