Provider Demographics
NPI:1124558689
Name:1 CHOICE HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:1 CHOICE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:GBLAH
Authorized Official - Last Name:MENDY
Authorized Official - Suffix:
Authorized Official - Credentials:RN(REGISTERED NURSE)
Authorized Official - Phone:856-433-8646
Mailing Address - Street 1:1409 E. HIGHWAY 70
Mailing Address - Street 2:BARCLAY PAVILION, SUITE 207W
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034
Mailing Address - Country:US
Mailing Address - Phone:856-433-8646
Mailing Address - Fax:856-433-8666
Practice Address - Street 1:1409 E. HIGHWAY 70
Practice Address - Street 2:BARCLAY PAVILION, SUITE 207W
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034
Practice Address - Country:US
Practice Address - Phone:856-433-8646
Practice Address - Fax:856-433-8666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0252500251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health