Provider Demographics
NPI:1316394885
Name:FIRST LINE SUPPORT, LLC
Entity Type:Organization
Organization Name:FIRST LINE SUPPORT, LLC
Other - Org Name:A PLUS PROVIDER SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BERTHA
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:TAMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-533-4079
Mailing Address - Street 1:3705 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-2420
Mailing Address - Country:US
Mailing Address - Phone:956-533-4079
Mailing Address - Fax:
Practice Address - Street 1:8463 E HWY 107
Practice Address - Street 2:SUITE E
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-1704
Practice Address - Country:US
Practice Address - Phone:956-252-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-15
Last Update Date:2016-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care