Provider Demographics
NPI:1083094874
Name:CHOICE CARE SERVICES, INC.
Entity Type:Organization
Organization Name:CHOICE CARE SERVICES, INC.
Other - Org Name:CHOICE CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TASSIE
Authorized Official - Middle Name:SHENITA
Authorized Official - Last Name:MCDANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:313-510-1625
Mailing Address - Street 1:18121 E 8 MILE RD
Mailing Address - Street 2:#303
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3245
Mailing Address - Country:US
Mailing Address - Phone:313-656-2409
Mailing Address - Fax:313-656-2411
Practice Address - Street 1:18121 E 8 MILE RD
Practice Address - Street 2:#303
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3245
Practice Address - Country:US
Practice Address - Phone:313-656-2409
Practice Address - Fax:313-656-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704154830253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6947086Medicaid