Provider Demographics
NPI:1568031359
Name:A1 COMMUNITY CHOICE LLC
Entity Type:Organization
Organization Name:A1 COMMUNITY CHOICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:DEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-269-8563
Mailing Address - Street 1:1551 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-3269
Mailing Address - Country:US
Mailing Address - Phone:321-269-8563
Mailing Address - Fax:321-269-8563
Practice Address - Street 1:1551 GARDEN ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-3269
Practice Address - Country:US
Practice Address - Phone:321-269-8563
Practice Address - Fax:321-269-8563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health