Provider Demographics
NPI:1871963124
Name:FIRST STEP CARE LLC
Entity type:Organization
Organization Name:FIRST STEP CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SLYVING
Authorized Official - Middle Name:DATON
Authorized Official - Last Name:BOURDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:407-470-5908
Mailing Address - Street 1:PO BOX 464
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:FL
Mailing Address - Zip Code:32768-0464
Mailing Address - Country:US
Mailing Address - Phone:407-470-5908
Mailing Address - Fax:
Practice Address - Street 1:365 WEKIVA SPRINGS RD STE 231
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3690
Practice Address - Country:US
Practice Address - Phone:407-470-5908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW115131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty