MEDICARE: FIRST CHOICE COMPANION SERVICES 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1184034803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE COMPANION SERVICES LLC

Provider Business Mailing Address
First Line	:	3891 10TH AVE N
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-2853
Country	:	US
Telephone Number	:	561-318-6889
Fax Number	:	561-360-3042

Provider Business Practice Location Address
First Line	:	3891 10TH AVE N
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-2853
Country	:	US
Telephone Number	:	561-318-6889
Fax Number	:	561-360-3042

Authorized Official
Title or Position	:	CEO
Name	:	MR. ENOCE JACQUES
Credential	:
Telephone Number	:	561-318-6889

Provider Enumeration Date	:	05/02/2014
Last Update Date	:	05/02/2014

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