Provider Demographics
NPI:1275869398
Name:A1 ADULT CARE SERVICES LLC
Entity Type:Organization
Organization Name:A1 ADULT CARE SERVICES LLC
Other - Org Name:A1 HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ALT. ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEWEL
Authorized Official - Middle Name:SHUNTEL
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-771-9111
Mailing Address - Street 1:2165 CLUBVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-3162
Mailing Address - Country:US
Mailing Address - Phone:972-771-9111
Mailing Address - Fax:469-533-0444
Practice Address - Street 1:2165 CLUBVIEW DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-3162
Practice Address - Country:US
Practice Address - Phone:972-771-9111
Practice Address - Fax:469-533-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN