Provider Demographics
NPI:1760729800
Name:FAMILY 1ST SENIOR CARE LLC
Entity Type:Organization
Organization Name:FAMILY 1ST SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAYLESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-823-9035
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:POWHATAN POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43942-0011
Mailing Address - Country:US
Mailing Address - Phone:888-823-9035
Mailing Address - Fax:
Practice Address - Street 1:55460 BRIAN ST
Practice Address - Street 2:
Practice Address - City:POWHATAN POINT
Practice Address - State:OH
Practice Address - Zip Code:43942-9755
Practice Address - Country:US
Practice Address - Phone:888-823-9035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2055010OtherOHIO SECRETARY OF STATE
WV99ST6OtherWEST VIRGINIA SECRETARY OF STATE