Provider Demographics
NPI:1518452721
Name:1ST CHOICE ADULT CENTER LLC
Entity Type:Organization
Organization Name:1ST CHOICE ADULT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:TRANEE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-942-1127
Mailing Address - Street 1:6344 GARESCHE AVE
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-3446
Mailing Address - Country:US
Mailing Address - Phone:314-942-1127
Mailing Address - Fax:314-279-1006
Practice Address - Street 1:6344 GARESCHE AVE
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:MO
Practice Address - Zip Code:63136-3446
Practice Address - Country:US
Practice Address - Phone:314-942-1127
Practice Address - Fax:314-279-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care