Provider Demographics
NPI:1659632214
Name:CHOICE CARE LLC
Entity Type:Organization
Organization Name:CHOICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:J B
Authorized Official - Last Name:RUCHTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-978-2167
Mailing Address - Street 1:PO BOX 57467
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-2467
Mailing Address - Country:US
Mailing Address - Phone:907-978-2167
Mailing Address - Fax:
Practice Address - Street 1:1805 ALDER ST
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-5422
Practice Address - Country:US
Practice Address - Phone:907-978-2167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK974581171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty