Provider Demographics
NPI:1043759277
Name:INTELLICHOICE STAFFING LLC
Entity Type:Organization
Organization Name:INTELLICHOICE STAFFING LLC
Other - Org Name:INTELLICHOICE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-215-5656
Mailing Address - Street 1:1922 TRADD CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6637
Mailing Address - Country:US
Mailing Address - Phone:910-400-3000
Mailing Address - Fax:
Practice Address - Street 1:1922 TRADD CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6637
Practice Address - Country:US
Practice Address - Phone:910-400-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4880251J00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC4880Medicaid