Provider Demographics
NPI:1235458068
Name:A-1 HEALTH & MEDICAL L.L.C.
Entity Type:Organization
Organization Name:A-1 HEALTH & MEDICAL L.L.C.
Other - Org Name:A-1 PERSONAL SERVICES AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:WILLISE
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTH FACILITY ADM
Authorized Official - Phone:317-690-4207
Mailing Address - Street 1:7002 GRAHAM RD.
Mailing Address - Street 2:SUITE #222
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4057
Mailing Address - Country:US
Mailing Address - Phone:317-202-9400
Mailing Address - Fax:317-252-8560
Practice Address - Street 1:7002 GRAHAM RD.
Practice Address - Street 2:SUITE #222
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4057
Practice Address - Country:US
Practice Address - Phone:317-202-9400
Practice Address - Fax:317-202-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10-012325-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN10-012325-1OtherWAIVER