Provider Demographics
NPI:1528597796
Name:1NINETYNINE1 LLC
Entity Type:Organization
Organization Name:1NINETYNINE1 LLC
Other - Org Name:FIRSTLIGHT HOME CARE OF WEST BROWARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LINCOLN
Authorized Official - Last Name:SIROTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-993-0019
Mailing Address - Street 1:16691 SW 49TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33331-1325
Mailing Address - Country:US
Mailing Address - Phone:954-993-0019
Mailing Address - Fax:
Practice Address - Street 1:16691 SW 49TH ST
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33331-1325
Practice Address - Country:US
Practice Address - Phone:954-993-0019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care