Provider Demographics
NPI:1316212905
Name:1ST CHOICE CARE HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:1ST CHOICE CARE HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:LENISE
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:216-269-7962
Mailing Address - Street 1:2101 APPLE DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1610
Mailing Address - Country:US
Mailing Address - Phone:216-269-7962
Mailing Address - Fax:
Practice Address - Street 1:12526 SAINT CLAIR AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-2016
Practice Address - Country:US
Practice Address - Phone:216-269-7962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health