Provider Demographics
NPI:1144754268
Name:FIRST STEP CLINICAL SERVICES LLC
Entity Type:Organization
Organization Name:FIRST STEP CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAMARVIN
Authorized Official - Middle Name:JOESPH
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MHSC,LCADC
Authorized Official - Phone:973-814-0435
Mailing Address - Street 1:695 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07504-2009
Mailing Address - Country:US
Mailing Address - Phone:973-814-0435
Mailing Address - Fax:
Practice Address - Street 1:159 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-1215
Practice Address - Country:US
Practice Address - Phone:973-814-0435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00246300261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)