Provider Demographics
NPI:1962701789
Name:FIRST STEP RECOVERY LLC
Entity type:Organization
Organization Name:FIRST STEP RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BHT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESUTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-574-0427
Mailing Address - Street 1:6107 E ENCANTO ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-5956
Mailing Address - Country:US
Mailing Address - Phone:602-574-0427
Mailing Address - Fax:480-649-3775
Practice Address - Street 1:749 S BALBOA CIR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4102
Practice Address - Country:US
Practice Address - Phone:602-574-0427
Practice Address - Fax:480-649-3775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-3611251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health