Provider Demographics
NPI:1225750359
Name:FIRST CARE 101K LLC
Entity Type:Organization
Organization Name:FIRST CARE 101K LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-858-2056
Mailing Address - Street 1:204 LOUIS CARTER RD
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39082-4117
Mailing Address - Country:US
Mailing Address - Phone:601-858-2056
Mailing Address - Fax:
Practice Address - Street 1:204 LOUIS CARTER RD
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:MS
Practice Address - Zip Code:39082-4117
Practice Address - Country:US
Practice Address - Phone:601-858-2056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health