Provider Demographics
NPI:1093581159
Name:FAMILY CHOICE HEALTHCARE
Entity Type:Organization
Organization Name:FAMILY CHOICE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PETTIFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-200-8996
Mailing Address - Street 1:980 BIRMINGHAM RD STE 501-304
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4417
Mailing Address - Country:US
Mailing Address - Phone:678-208-3437
Mailing Address - Fax:678-208-3437
Practice Address - Street 1:510 TULLAMORE WAY
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-2643
Practice Address - Country:US
Practice Address - Phone:678-200-8996
Practice Address - Fax:678-208-3437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health