Provider Demographics
NPI:1194003665
Name:1ST CHOICE HOME CARE, INC.
Entity Type:Organization
Organization Name:1ST CHOICE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YAROSLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-559-0200
Mailing Address - Street 1:90 OAK ST STE 405
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1439
Mailing Address - Country:US
Mailing Address - Phone:617-559-0200
Mailing Address - Fax:617-663-6319
Practice Address - Street 1:90 OAK ST STE 405
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02464-1439
Practice Address - Country:US
Practice Address - Phone:617-559-0200
Practice Address - Fax:617-663-6319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency