Provider Demographics
NPI:1003128984
Name:FIRST CARE
Entity Type:Organization
Organization Name:FIRST CARE
Other - Org Name:SHIRLEY SMITH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LACARINGTON
Authorized Official - Middle Name:DOMINIQUE
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:601-892-7350
Mailing Address - Street 1:506 W MARION AVE
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39059-2711
Mailing Address - Country:US
Mailing Address - Phone:601-892-7350
Mailing Address - Fax:601-892-7351
Practice Address - Street 1:506 W MARION AVE
Practice Address - Street 2:SUITE H
Practice Address - City:CRYSTAL SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39059-2711
Practice Address - Country:US
Practice Address - Phone:601-892-7350
Practice Address - Fax:601-892-7351
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRST CARE 506 LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSAO62588251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care