Provider Demographics
NPI:1083801963
Name:MY CHOICE IN-HOME CARE LLC
Entity Type:Organization
Organization Name:MY CHOICE IN-HOME CARE LLC
Other - Org Name:MY CHOICE IN-HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
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, MS, QME
Authorized Official - Phone:951-244-8770
Mailing Address - Street 1:31610 RAILROAD CANYON RD STE 5
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:951-244-7622
Mailing Address - Fax:951-246-2657
Practice Address - Street 1:31610 RAILROAD CANYON RD STE 5
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:951-244-7622
Practice Address - Fax:951-246-2657
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MY CHOICE IN-HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care