Provider Demographics
NPI:1952840209
Name:FIRSTLIGHT HOME CARE OF WACO
Entity Type:Organization
Organization Name:FIRSTLIGHT HOME CARE OF WACO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:STERLING
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-313-2511
Mailing Address - Street 1:110 JIM DR
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:TX
Mailing Address - Zip Code:76643-2968
Mailing Address - Country:US
Mailing Address - Phone:254-313-2511
Mailing Address - Fax:
Practice Address - Street 1:110 JIM DR
Practice Address - Street 2:
Practice Address - City:HEWITT
Practice Address - State:TX
Practice Address - Zip Code:76643-2968
Practice Address - Country:US
Practice Address - Phone:254-313-2511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASSK HILL 5 INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care