Provider Demographics
NPI:1326037441
Name:CARECHOICE LTD
Entity Type:Organization
Organization Name:CARECHOICE LTD
Other - Org Name:CARECHOICE OF BOERNE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:830-249-2594
Mailing Address - Street 1:200 EAST RYAN ST
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2046
Mailing Address - Country:US
Mailing Address - Phone:830-249-2594
Mailing Address - Fax:830-248-1314
Practice Address - Street 1:200 EAST RYAN ST
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2046
Practice Address - Country:US
Practice Address - Phone:830-249-2594
Practice Address - Fax:830-248-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001004886Medicaid
TX001004886Medicaid