Provider Demographics
NPI:1144710765
Name:MAJOR 1 COMPANION SERVICES
Entity type:Organization
Organization Name:MAJOR 1 COMPANION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROC-ROZA
Authorized Official - Middle Name:OKAI
Authorized Official - Last Name:HILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-777-1614
Mailing Address - Street 1:8369 MALTBY RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3139
Mailing Address - Country:US
Mailing Address - Phone:352-777-1614
Mailing Address - Fax:352-600-8388
Practice Address - Street 1:8369 MALTBY RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-3139
Practice Address - Country:US
Practice Address - Phone:352-777-1614
Practice Address - Fax:352-600-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253Z00000X
FL235151253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002400800Medicaid
FL019356200Medicaid