Provider Demographics
NPI:1699245423
Name:FIRST STEP LIVING TEXAS LLC
Entity type:Organization
Organization Name:FIRST STEP LIVING TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-280-2802
Mailing Address - Street 1:5333 RICHMOND AVE APT 25
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6690
Mailing Address - Country:US
Mailing Address - Phone:203-280-2802
Mailing Address - Fax:
Practice Address - Street 1:5333 RICHMOND AVE APT 25
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6690
Practice Address - Country:US
Practice Address - Phone:203-280-2802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health