Provider Demographics
NPI:1083622187
Name:FIRST CHOICE HOME HEALTH & HOSPICE SPECIALISTS, INC.
Entity Type:Organization
Organization Name:FIRST CHOICE HOME HEALTH & HOSPICE SPECIALISTS, INC.
Other - Org Name:FIRST CHOICE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:BEAU
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-434-4100
Mailing Address - Street 1:560 W 800 N # 204
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-3746
Mailing Address - Country:US
Mailing Address - Phone:801-434-4100
Mailing Address - Fax:801-434-8899
Practice Address - Street 1:560 W 800 N # 204
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3746
Practice Address - Country:US
Practice Address - Phone:801-434-4100
Practice Address - Fax:801-434-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2006-HOSPICE-67294251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========001Medicaid
UT=========001Medicaid