Provider Demographics
NPI:1447343009
Name:FIRST STEP ADOLESCENT SERVICES, INC.
Entity type:Organization
Organization Name:FIRST STEP ADOLESCENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:ANITA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-327-2901
Mailing Address - Street 1:125 EXCELSIOR PKWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-2569
Mailing Address - Country:US
Mailing Address - Phone:407-327-2901
Mailing Address - Fax:407-327-2780
Practice Address - Street 1:459 LAKE OPAL CT
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-6968
Practice Address - Country:US
Practice Address - Phone:407-880-3894
Practice Address - Fax:407-880-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0748AD1209013245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children