Provider Demographics
NPI:1083388805
Name:PEOPLE 1ST HEALTH AND RESIDENTIAL SERVICES, LLC
Entity Type:Organization
Organization Name:PEOPLE 1ST HEALTH AND RESIDENTIAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAYFIELD
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPTA/ATC
Authorized Official - Phone:804-638-3838
Mailing Address - Street 1:13606 MANGROVE BAY DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-5854
Mailing Address - Country:US
Mailing Address - Phone:804-638-3836
Mailing Address - Fax:
Practice Address - Street 1:13703 RAMBLEWOOD DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-5538
Practice Address - Country:US
Practice Address - Phone:804-638-3836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities