Provider Demographics
NPI:1598379067
Name:FIRST STEP WELLNESS LLC
Entity Type:Organization
Organization Name:FIRST STEP WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAGER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNPBC, FNPC
Authorized Official - Phone:515-339-9478
Mailing Address - Street 1:14321 DELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-2096
Mailing Address - Country:US
Mailing Address - Phone:515-339-9478
Mailing Address - Fax:515-987-7872
Practice Address - Street 1:14321 DELLWOOD DR
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50323-2096
Practice Address - Country:US
Practice Address - Phone:515-339-9478
Practice Address - Fax:515-987-7872
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JUDITH M HAGER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health