Provider Demographics
NPI:1699963736
Name:FIRST HOME CARE CORPORATION
Entity type:Organization
Organization Name:FIRST HOME CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-966-1864
Mailing Address - Street 1:7170 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2301
Mailing Address - Country:US
Mailing Address - Phone:215-641-5300
Mailing Address - Fax:615-653-7872
Practice Address - Street 1:111 N 49TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-2718
Practice Address - Country:US
Practice Address - Phone:215-472-7291
Practice Address - Fax:215-472-7296
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABS LINCS VA,INC FIRST HOME CARE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-12
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA122010101YP2500X, 251S00000X, 261Q00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016843230001Medicaid