Provider Demographics
NPI:1639764459
Name:1ST CHOICE CONSUMER DIRECTED SERVICES, INC.
Entity Type:Organization
Organization Name:1ST CHOICE CONSUMER DIRECTED SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIMADEEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-300-1200
Mailing Address - Street 1:21725 N 20TH AVE
Mailing Address - Street 2:SUITE 101-102 #1065
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-2640
Mailing Address - Country:US
Mailing Address - Phone:623-300-1200
Mailing Address - Fax:623-666-6772
Practice Address - Street 1:21725 N 20TH AVE
Practice Address - Street 2:SUITE 101-102 #1065
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-2640
Practice Address - Country:US
Practice Address - Phone:623-300-1200
Practice Address - Fax:623-666-6772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care