Provider Demographics
NPI:1376839811
Name:1ST CHOICE CARE FACILITY
Entity Type:Organization
Organization Name:1ST CHOICE CARE FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMAT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:469-688-9800
Mailing Address - Street 1:4604 PUTNAM DR.
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024
Mailing Address - Country:US
Mailing Address - Phone:469-688-9800
Mailing Address - Fax:972-692-8080
Practice Address - Street 1:4604 PUTNAM DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-6324
Practice Address - Country:US
Practice Address - Phone:469-688-9800
Practice Address - Fax:972-692-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility