Provider Demographics
NPI:1609308964
Name:MYCHOICE SOLUTIONS LLC
Entity Type:Organization
Organization Name:MYCHOICE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOCIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-297-7931
Mailing Address - Street 1:PO BOX 329
Mailing Address - Street 2:
Mailing Address - City:GARRETTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44231-0329
Mailing Address - Country:US
Mailing Address - Phone:330-297-7931
Mailing Address - Fax:
Practice Address - Street 1:13020 TILDEN RD
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:OH
Practice Address - Zip Code:44234-9725
Practice Address - Country:US
Practice Address - Phone:330-297-7931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty