Provider Demographics
NPI:1134783194
Name:FIRST STEP MEDICAL LLC
Entity type:Organization
Organization Name:FIRST STEP MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:865-465-7088
Mailing Address - Street 1:3651 WINFIELD DUNN PKWY
Mailing Address - Street 2:
Mailing Address - City:KODAK
Mailing Address - State:TN
Mailing Address - Zip Code:37764-1471
Mailing Address - Country:US
Mailing Address - Phone:865-465-7088
Mailing Address - Fax:888-909-9643
Practice Address - Street 1:754 EAST MAIN ST.
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-5014
Practice Address - Country:US
Practice Address - Phone:276-415-9600
Practice Address - Fax:276-415-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder