Provider Demographics
NPI:1528409091
Name:MY CHOICE SENIOR SERVICES
Entity Type:Organization
Organization Name:MY CHOICE SENIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:951-695-2306
Mailing Address - Street 1:31610 STE 4 RAILROAD CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92587-9454
Mailing Address - Country:US
Mailing Address - Phone:951-695-2306
Mailing Address - Fax:
Practice Address - Street 1:31610 STE 4 RAILROAD CANYON RD
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:CA
Practice Address - Zip Code:92587-9454
Practice Address - Country:US
Practice Address - Phone:951-695-2306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0893253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care