Provider Demographics
NPI:1548389778
Name:SENIOR CHOICES UNLIMITED LLC
Entity Type:Organization
Organization Name:SENIOR CHOICES UNLIMITED LLC
Other - Org Name:HEALTHMATE HOMECARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CUSTOMER SERVICE REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:BLACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-803-2155
Mailing Address - Street 1:5710 OLEANDER DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4723
Mailing Address - Country:US
Mailing Address - Phone:910-803-2155
Mailing Address - Fax:910-803-2220
Practice Address - Street 1:5710 OLEANDER DR STE 102
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4723
Practice Address - Country:US
Practice Address - Phone:910-803-2155
Practice Address - Fax:910-803-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
NC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600811Medicaid
NC6600811NCMedicaid