Provider Demographics
NPI:1285858878
Name:FIRST STEP DENTON COUNTY OUTREACH PROGRAM, LLC
Entity Type:Organization
Organization Name:FIRST STEP DENTON COUNTY OUTREACH PROGRAM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CULBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-484-7837
Mailing Address - Street 1:1314 TEASLEY LANE
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205
Mailing Address - Country:US
Mailing Address - Phone:940-484-7837
Mailing Address - Fax:
Practice Address - Street 1:1314 TEASLEY LANE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205
Practice Address - Country:US
Practice Address - Phone:940-484-7837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2518-A251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)