Provider Demographics
NPI:1275947715
Name:YOUR CHOICE HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:YOUR CHOICE HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-255-0620
Mailing Address - Street 1:254 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2641
Mailing Address - Country:US
Mailing Address - Phone:304-255-0620
Mailing Address - Fax:304-256-8204
Practice Address - Street 1:530 GRAY GABLES RD
Practice Address - Street 2:
Practice Address - City:CRAWLEY
Practice Address - State:WV
Practice Address - Zip Code:24931-9738
Practice Address - Country:US
Practice Address - Phone:304-392-6270
Practice Address - Fax:304-392-6354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWVM0004468377251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management