Provider Demographics
NPI:1457910937
Name:CAREFIRST SUPPORT SERVICES, LLC
Entity Type:Organization
Organization Name:CAREFIRST SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-789-1302
Mailing Address - Street 1:PO BOX 37984
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32236-7984
Mailing Address - Country:US
Mailing Address - Phone:904-554-8372
Mailing Address - Fax:
Practice Address - Street 1:6722 ARLINGTON EXPY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-7234
Practice Address - Country:US
Practice Address - Phone:904-554-8372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104487900Medicaid