Provider Demographics
NPI:1205893633
Name:PERSONAL CHOICE HOME HEALTH SERVICES,INC.
Entity type:Organization
Organization Name:PERSONAL CHOICE HOME HEALTH SERVICES,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CASELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-946-1920
Mailing Address - Street 1:41 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4304
Mailing Address - Country:US
Mailing Address - Phone:954-946-1920
Mailing Address - Fax:954-946-8338
Practice Address - Street 1:5400 S BISCAYNE DR
Practice Address - Street 2:F
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-1932
Practice Address - Country:US
Practice Address - Phone:941-429-9009
Practice Address - Fax:941-423-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21890095251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
107520Medicare ID - Type Unspecified