Provider Demographics
NPI:1043254899
Name:PATIENT CHOICE HOME HEALTH AGENCY
Entity type:Organization
Organization Name:PATIENT CHOICE HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:NARCISSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-742-5163
Mailing Address - Street 1:7771 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6749
Mailing Address - Country:US
Mailing Address - Phone:954-742-5163
Mailing Address - Fax:954-742-5169
Practice Address - Street 1:7771 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6749
Practice Address - Country:US
Practice Address - Phone:954-742-5163
Practice Address - Fax:954-742-5169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21653096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21653096OtherAGENCY LICENSE