MEDICARE: 1ST CHOICE CARE HOME HEALTH AGENCY

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	:	1316212905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1ST CHOICE CARE HOME HEALTH AGENCY

Provider Business Mailing Address
First Line	:	2101 APPLE DR
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44143-1610
Country	:	US
Telephone Number	:	216-269-7962
Fax Number	:

Provider Business Practice Location Address
First Line	:	12526 SAINT CLAIR AVE
Second Line	:	SUITE 2
City	:	CLEVELAND
State	:	OH
Zip	:	44108-2016
Country	:	US
Telephone Number	:	216-269-7962
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. CARLA LENISE CLAYTON
Credential	:	BA
Telephone Number	:	216-269-7962

Provider Enumeration Date	:	03/14/2012
Last Update Date	:	03/14/2012

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Directions to “1ST CHOICE CARE HOME HEALTH AGENCY ” Practice Location

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