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General NPI Number Information
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NPI Number | 1245788421
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Entity Type | Organization
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Legal Business Name | 1ST ADVANTAGE HEALTHCARE ALLIANCE, LLC
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Dates
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Enumeration Date | 09/15/2016
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 1840 MAIN ST SUITE 202
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City | WESTON
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State | FL
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Zip | 33326-3685
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Country | US
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Telephone | 954-257-7290
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Fax |
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Provider Business Mailing Address
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Address Line | 1840 MAIN ST SUITE 202
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City | WESTON
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State | FL
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Zip | 33326-3685
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CELESIA VALENTINE
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Credential |
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Telephone | 954-257-7290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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