Provider Demographics
NPI:1326220195
Name:FIRST CHOICE HOMEMAKER SERVICES INC.
Entity Type:Organization
Organization Name:FIRST CHOICE HOMEMAKER SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:662-686-4542
Mailing Address - Street 1:123 ROTH RD
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38756-9416
Mailing Address - Country:US
Mailing Address - Phone:662-686-4542
Mailing Address - Fax:662-686-0350
Practice Address - Street 1:123 ROTH RD
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:MS
Practice Address - Zip Code:38756-9416
Practice Address - Country:US
Practice Address - Phone:662-686-4542
Practice Address - Fax:662-686-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS05050805253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05050805Medicaid
MS06672071Medicaid