Provider Demographics
NPI:1104298876
Name:1ST ACCESS, LLC
Entity type:Organization
Organization Name:1ST ACCESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARRIAN
Authorized Official - Middle Name:JUJUAN
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-503-9865
Mailing Address - Street 1:9504 E 63RD ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-4948
Mailing Address - Country:US
Mailing Address - Phone:816-503-9865
Mailing Address - Fax:816-503-9408
Practice Address - Street 1:9504 E 63RD ST
Practice Address - Street 2:SUITE 214
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-4948
Practice Address - Country:US
Practice Address - Phone:816-503-9865
Practice Address - Fax:816-503-9408
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCESS HOME HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care