Provider Demographics
NPI:1043756141
Name:MY CHOICE SENIOR CARE INC
Entity Type:Organization
Organization Name:MY CHOICE SENIOR CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERER
Authorized Official - Suffix:
Authorized Official - Credentials:DC RETIRED
Authorized Official - Phone:909-556-4756
Mailing Address - Street 1:31610 RAILROAD CANYON RD STE 4
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92587-9454
Mailing Address - Country:US
Mailing Address - Phone:909-556-4756
Mailing Address - Fax:
Practice Address - Street 1:31610 RAILROAD CANYON RD STE 4
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:CA
Practice Address - Zip Code:92587-9454
Practice Address - Country:US
Practice Address - Phone:909-556-4756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care