Provider Demographics
NPI:1346609690
Name:PSALM 127 LLC
Entity Type:Organization
Organization Name:PSALM 127 LLC
Other - Org Name:FIRSTLIGHT HOMECARE OF THE TREASURE COAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:SENCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-360-6453
Mailing Address - Street 1:1331 SE PORT ST LUCIE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5331
Mailing Address - Country:US
Mailing Address - Phone:772-207-0309
Mailing Address - Fax:
Practice Address - Street 1:1595 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5431
Practice Address - Country:US
Practice Address - Phone:772-207-0309
Practice Address - Fax:772-777-3446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care