Provider Demographics
NPI:1184426181
Name:1ST PLACE HOME AND DAY SERVICES
Entity type:Organization
Organization Name:1ST PLACE HOME AND DAY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPIVA
Authorized Official - Suffix:I
Authorized Official - Credentials:BA, CESP
Authorized Official - Phone:234-214-2733
Mailing Address - Street 1:1509 BAYCREST DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-3083
Mailing Address - Country:US
Mailing Address - Phone:234-214-2733
Mailing Address - Fax:
Practice Address - Street 1:429 4TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-1819
Practice Address - Country:US
Practice Address - Phone:234-214-2733
Practice Address - Fax:000-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-27
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services