Provider Demographics
NPI:1851616866
Name:FIRST STEPS TO SUCCESS LLC
Entity type:Organization
Organization Name:FIRST STEPS TO SUCCESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-310-0600
Mailing Address - Street 1:909 WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-1981
Mailing Address - Country:US
Mailing Address - Phone:708-310-0600
Mailing Address - Fax:708-747-6607
Practice Address - Street 1:501 SYCAMORE ST
Practice Address - Street 2:SUITE 507
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-4644
Practice Address - Country:US
Practice Address - Phone:319-233-2500
Practice Address - Fax:319-233-2505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAX000205333Medicaid