Provider Demographics
NPI:1457799421
Name:FIRSTCARE HOMEHEALTH SERVICES LLC
Entity type:Organization
Organization Name:FIRSTCARE HOMEHEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERETAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-226-5622
Mailing Address - Street 1:5783 DAFFODIL CT
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-9456
Mailing Address - Country:US
Mailing Address - Phone:614-226-5622
Mailing Address - Fax:
Practice Address - Street 1:5783 DAFFODIL CT
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9456
Practice Address - Country:US
Practice Address - Phone:614-226-5622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health