Provider Demographics
NPI:1043459779
Name:1ST CHOICE HEALTHCARE SERVICES, LLC.
Entity Type:Organization
Organization Name:1ST CHOICE HEALTHCARE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:ESTEBAN
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:863-422-3600
Mailing Address - Street 1:705 INGRAHAM AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-4327
Mailing Address - Country:US
Mailing Address - Phone:863-422-3600
Mailing Address - Fax:863-422-4380
Practice Address - Street 1:705 INGRAHAM AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-4327
Practice Address - Country:US
Practice Address - Phone:863-422-3600
Practice Address - Fax:863-422-4380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
FL299993417251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
109362Medicare PIN