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General NPI Number Information
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NPI Number | 1639448723
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE ADULT DAYCARE AND HOME HEALTH CA
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Dates
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Enumeration Date | 12/20/2011
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 5336 QUAN DRIVE
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City | JACKSONVILLE
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State | FL
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Zip | 32205
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Country | US
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Telephone | 904-525-2918
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Fax |
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Provider Business Mailing Address
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Address Line | 5336 QUAN DRIVE
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City | JACKSONVILLE
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State | FL
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Zip | 32205
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Country | US
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Telephone | 904-525-2918
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MRS. SUZETTE DENISE MILEY-PEARSON
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Credential | BS, CMA, CNA
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Telephone | 904-525-2918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 641306NCMA
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 103413CNA
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License Number State | FL
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