Provider Demographics
NPI: | 1174208565 |
---|---|
Name: | 1ST PRIORITY AFH |
Entity type: | Organization |
Organization Name: | 1ST PRIORITY AFH |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | VICTORIA |
Authorized Official - Middle Name: | MICHELLE |
Authorized Official - Last Name: | STERBA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 262-752-3620 |
Mailing Address - Street 1: | 2523 CHARLES ST |
Mailing Address - Street 2: | |
Mailing Address - City: | RACINE |
Mailing Address - State: | WI |
Mailing Address - Zip Code: | 53402-4311 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 262-752-3620 |
Mailing Address - Fax: | 207-987-7091 |
Practice Address - Street 1: | 2523 CHARLES ST |
Practice Address - Street 2: | |
Practice Address - City: | RACINE |
Practice Address - State: | WI |
Practice Address - Zip Code: | 53402-4311 |
Practice Address - Country: | US |
Practice Address - Phone: | 262-752-3620 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-06-21 |
Last Update Date: | 2023-06-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
No | 251B00000X | Agencies | Case Management | |
No | 251E00000X | Agencies | Home Health | |
No | 251G00000X | Agencies | Hospice Care, Community Based | |
No | 251T00000X | Agencies | Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | |
No | 253Z00000X | Agencies | In Home Supportive Care | |
No | 261QA0005X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Family Planning Facility |
No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
No | 3104A0630X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Behavioral Disturbances |
No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
No | 342000000X | Transportation Services | Transportation Network Company | |
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
No | 385H00000X | Respite Care Facility | Respite Care |