MEDICARE: FIRST CHOICE HOME HEALTH 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	251E00000X	Home Health Agency	3829 HHA-3	NV

General Provider Information

NPI Number	:	1184650442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	2680 S JONES BLVD STE 2
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5634
Country	:	US
Telephone Number	:	702-227-0005
Fax Number	:	702-857-8443

Provider Business Practice Location Address
First Line	:	2680 S JONES BLVD STE 2
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5634
Country	:	US
Telephone Number	:	702-227-0005
Fax Number	:	702-857-8443

Authorized Official
Title or Position	:	CEO / ADMINISTRATOR
Name	:	MARY GRACE SUDARIO GRECIA
Credential	:
Telephone Number	:	702-227-0005

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	02/27/2020

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