Basic Information
| Provider Information | |||||||||
| NPI: | 1679533905 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FIRST STEP, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10400 RIDGLAND RD | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | COCKEYSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210302715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106286210 | ||||||||
| FaxNumber: | 4106289825 | ||||||||
| Practice Location | |||||||||
| Address1: | 7801 YORK RD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212047446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9999999999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2006 | ||||||||
| LastUpdateDate: | 12/03/2014 | ||||||||
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| AuthorizedOfficialLastName: | BITTINGER | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS OPERATIONS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4106286120 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | 101834 | MD | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
ID Information
| ID | Type | State | Issuer | Description | 327609 | 01 | MD | VALUE OPTIONS | OTHER | 766211400 | 05 | MD | MEDICAID | 116651403 | 05 | MD | MEDICAID | 236380 | 01 | MD | AMERIGROUP | OTHER |