Provider Demographics
NPI:1689906836
Name:FIRST STATE HOME CARE LLC
Entity Type:Organization
Organization Name:FIRST STATE HOME CARE LLC
Other - Org Name:DELAWARE COMPANION & RESPITE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-655-4249
Mailing Address - Street 1:5205 W WOODMILL DR
Mailing Address - Street 2:SUITE 33 LOWER LEVEL
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4068
Mailing Address - Country:US
Mailing Address - Phone:302-655-4249
Mailing Address - Fax:888-459-2609
Practice Address - Street 1:5205 W WOODMILL DR
Practice Address - Street 2:SUITE 33 LOWER LEVEL
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4068
Practice Address - Country:US
Practice Address - Phone:302-655-4249
Practice Address - Fax:888-459-2609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care