MEDICARE: PREFERRED 1 HOME CARE 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1134062185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED 1 HOME CARE LLC

Provider Business Mailing Address
First Line	:	2413 ELLEN AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-6785
Country	:	US
Telephone Number	:	704-460-9066
Fax Number	:

Provider Business Practice Location Address
First Line	:	2413 ELLEN AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-6785
Country	:	US
Telephone Number	:	704-460-9066
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JADAJAH T MAHATHA
Credential	:
Telephone Number	:	704-460-9066

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “PREFERRED 1 HOME CARE LLC ” Practice Location

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