Provider Demographics
NPI:1619305745
Name:SENIORS CHOICE HOME CARE, LLC
Entity Type:Organization
Organization Name:SENIORS CHOICE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSM
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-315-0301
Mailing Address - Street 1:4112 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16511-1968
Mailing Address - Country:US
Mailing Address - Phone:814-315-0319
Mailing Address - Fax:
Practice Address - Street 1:4112 MAIN ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16511-1968
Practice Address - Country:US
Practice Address - Phone:814-315-0319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIORS CHOICE HOME CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-29
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA95460496251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health