Provider Demographics
NPI:1497170609
Name:AT HOME BY CHOICE INC.
Entity Type:Organization
Organization Name:AT HOME BY CHOICE INC.
Other - Org Name:COMPLETE PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:405-879-3470
Mailing Address - Street 1:1232 SW 89TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-9105
Mailing Address - Country:US
Mailing Address - Phone:405-879-3470
Mailing Address - Fax:405-879-1625
Practice Address - Street 1:1232 SW 89TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9105
Practice Address - Country:US
Practice Address - Phone:405-879-3470
Practice Address - Fax:405-879-1625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK7974OtherSTATE LICENSE
OK7974OtherSTATE LICENSE