Provider Demographics
NPI:1790170959
Name:A1 AMERICA HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:A1 AMERICA HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-221-8410
Mailing Address - Street 1:2454 WINKLER AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9266
Mailing Address - Country:US
Mailing Address - Phone:239-221-8410
Mailing Address - Fax:239-465-4510
Practice Address - Street 1:2454 WINKLER AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9266
Practice Address - Country:US
Practice Address - Phone:239-221-8410
Practice Address - Fax:239-465-4510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016310200Medicaid