Basic Information
| Provider Information | |||||||||
| NPI: | 1154506301 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | F.I.R.S.T. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 121 SHILOH RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288031626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282771315 | ||||||||
| FaxNumber: | 8282771321 | ||||||||
| Practice Location | |||||||||
| Address1: | 121 SHILOH RD | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288031626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282771315 | ||||||||
| FaxNumber: | 8282771321 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2008 | ||||||||
| LastUpdateDate: | 05/22/2009 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | PRICE-FERREELL | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8282771315 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | Y | Agencies | Case Management |
No ID Information.