Provider Demographics
NPI:1508863564
Name:CHOICE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CHOICE HEALTH SERVICES, INC.
Other - Org Name:CHOICE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAHLA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:979-774-5451
Mailing Address - Street 1:3201 UNIVERSITY DR E
Mailing Address - Street 2:SUITE 475
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3475
Mailing Address - Country:US
Mailing Address - Phone:979-774-5451
Mailing Address - Fax:979-774-1961
Practice Address - Street 1:3201 UNIVERSITY DR E
Practice Address - Street 2:SUITE 475
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3475
Practice Address - Country:US
Practice Address - Phone:979-774-5451
Practice Address - Fax:979-774-1961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-06
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004358251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0250904-01Medicaid
TX678303Medicare ID - Type UnspecifiedHOME HEALTH