Provider Demographics
NPI:1700387297
Name:INTELLICHOICE STAFFING LLC
Entity Type:Organization
Organization Name:INTELLICHOICE STAFFING LLC
Other - Org Name:INTELLICHOICE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-215-5656
Mailing Address - Street 1:4735 REEDY BRANCH RD STE A
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9934
Mailing Address - Country:US
Mailing Address - Phone:252-215-5656
Mailing Address - Fax:
Practice Address - Street 1:5 DUNDAS CIR STE F
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1638
Practice Address - Country:US
Practice Address - Phone:336-307-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTELLICHOICE STAFFING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-21
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC4987Medicaid