Provider Demographics
NPI:1164035077
Name:FAMILY CHOICE COMMUNITY SERVICES LLC
Entity Type:Organization
Organization Name:FAMILY CHOICE COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:917-373-5332
Mailing Address - Street 1:102 RUBY DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5928
Mailing Address - Country:US
Mailing Address - Phone:917-373-5332
Mailing Address - Fax:
Practice Address - Street 1:102 RUBY DR
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5928
Practice Address - Country:US
Practice Address - Phone:917-373-5332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450529055Medicaid