MEDICARE: COMPLETE CHOICE HOME CARE 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	:	1679451074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE CHOICE HOME CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	10141 SW VILLAGE PKWY
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34987-2652
Country	:	US
Telephone Number	:	772-979-3343
Fax Number	:

Provider Business Practice Location Address
First Line	:	10141 SW VILLAGE PKWY
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34987-2652
Country	:	US
Telephone Number	:	772-979-3343
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CRYSTAL CARR-KING
Credential	:
Telephone Number	:	772-979-3343

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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