Provider Demographics
NPI:1467947747
Name:1 ON 1 HOLDINGS LLC
Entity Type:Organization
Organization Name:1 ON 1 HOLDINGS LLC
Other - Org Name:1 ON 1 COMPANION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-554-5655
Mailing Address - Street 1:1831 SW 91ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7606
Mailing Address - Country:US
Mailing Address - Phone:954-554-5655
Mailing Address - Fax:
Practice Address - Street 1:1831 SW 91ST AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7606
Practice Address - Country:US
Practice Address - Phone:954-554-5655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235433251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0Medicaid