MEDICARE: FIRST STEPS

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1568615003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST STEPS

Provider Business Mailing Address
First Line	:	2828 HANNA PL
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1496
Country	:	US
Telephone Number	:	606-669-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2828 HANNA PL
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1496
Country	:	US
Telephone Number	:	606-669-1030
Fax Number	:

Authorized Official
Title or Position	:	SERVICE PROVIDER
Name	:	MS. CRYSTAL RENEE GOFORTH
Credential	:	BS
Telephone Number	:	606-669-1030

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	10/28/2008

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Directions to “FIRST STEPS ” Practice Location

Language	Start Address	Practice Location

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