Provider Demographics
NPI:1619595303
Name:PERSONAL CHOICE HOME CARE LLC
Entity Type:Organization
Organization Name:PERSONAL CHOICE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-442-0082
Mailing Address - Street 1:8144 CONGRESSWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1304
Mailing Address - Country:US
Mailing Address - Phone:513-442-0082
Mailing Address - Fax:
Practice Address - Street 1:19 N 9TH ST
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-4304
Practice Address - Country:US
Practice Address - Phone:513-442-0082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty