Provider Demographics
NPI:1225350978
Name:M.E. F.I.R.S.T. LLC
Entity Type:Organization
Organization Name:M.E. F.I.R.S.T. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOULDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-756-7987
Mailing Address - Street 1:PO BOX 2212
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06722-2212
Mailing Address - Country:US
Mailing Address - Phone:203-756-7897
Mailing Address - Fax:203-754-2118
Practice Address - Street 1:77 BISHOP ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06704-3306
Practice Address - Country:US
Practice Address - Phone:203-756-7987
Practice Address - Fax:203-754-2118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty