MEDICARE: A BETTER CHOICE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1639573645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A BETTER CHOICE, LLC

Provider Business Mailing Address
First Line	:	2121 W PALMETTO ST
Second Line	:	SUITE D
City	:	FLORENCE
State	:	SC
Zip	:	29501-3938
Country	:	US
Telephone Number	:	813-541-0087
Fax Number	:

Provider Business Practice Location Address
First Line	:	8621 SANDY PLAINS DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-8617
Country	:	US
Telephone Number	:	813-368-0673
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. JERALYN GAY
Credential	:
Telephone Number	:	813-541-0087

Provider Enumeration Date	:	10/20/2014
Last Update Date	:	10/20/2014

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