Provider Demographics
NPI:1285520874
Name:FIRST CLASS HOME CARE LLC
Entity type:Organization
Organization Name:FIRST CLASS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAY-TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-800-5009
Mailing Address - Street 1:1847 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-2477
Mailing Address - Country:US
Mailing Address - Phone:262-800-5009
Mailing Address - Fax:
Practice Address - Street 1:1847 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-2477
Practice Address - Country:US
Practice Address - Phone:262-800-5009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty