Provider Demographics
NPI:1245788421
Name:1ST ADVANTAGE HEALTHCARE ALLIANCE, LLC
Entity Type:Organization
Organization Name:1ST ADVANTAGE HEALTHCARE ALLIANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CELESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-257-7290
Mailing Address - Street 1:1840 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3685
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1840 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3685
Practice Address - Country:US
Practice Address - Phone:954-257-7290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health