1922157403 NPI number — FIRST STEP, INC.

Table of content: (NPI 1922157403)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922157403 NPI number — FIRST STEP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRST STEP, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PARK PLACE 1 GROUP HOME, PARK PLACE 2 GROUP HOME
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922157403
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2440
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOT SPRINGS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
71914-2440
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-624-6468
Provider Business Mailing Address Fax Number:
501-624-1075

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
407 CARSON STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOT SPRINGS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-624-6468
Provider Business Practice Location Address Fax Number:
501-624-1075
Provider Enumeration Date:
01/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BLAND
Authorized Official First Name:
PAM
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
501-624-6468

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  102478724 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 116135742 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 131986720 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 136347772 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 121127732 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 129698774 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102478724 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 125880767 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 130552782 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 118207715 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 132516786 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 145873778 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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