Provider Demographics
NPI:1043964885
Name:FIRST HEALTH SERVICES LLC
Entity type:Organization
Organization Name:FIRST HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STANISLUS
Authorized Official - Middle Name:EBAI
Authorized Official - Last Name:EBAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:240-615-6881
Mailing Address - Street 1:354 MONTECRISTO CT
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-3440
Mailing Address - Country:US
Mailing Address - Phone:240-615-6881
Mailing Address - Fax:
Practice Address - Street 1:4411 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5639
Practice Address - Country:US
Practice Address - Phone:240-615-6881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-10
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health