Provider Demographics
NPI:1659614238
Name:PERSON CENTERED CHOICES, LLC
Entity Type:Organization
Organization Name:PERSON CENTERED CHOICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-525-5101
Mailing Address - Street 1:615 W MAIN ST., STE. 204
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743
Mailing Address - Country:US
Mailing Address - Phone:423-525-5101
Mailing Address - Fax:423-525-4938
Practice Address - Street 1:615 W. MAIN ST., STE. 204
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743
Practice Address - Country:US
Practice Address - Phone:423-525-5101
Practice Address - Fax:423-525-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747A0650X253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN376K00000XMedicaid
TN3747A0650XMedicaid
TN376J00000XMedicaid