Provider Demographics
NPI:1710447644
Name:MYCHOICE HOME CARE LLC
Entity Type:Organization
Organization Name:MYCHOICE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNA MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUGISHA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-547-0635
Mailing Address - Street 1:5120 LEERAY RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-9233
Mailing Address - Country:US
Mailing Address - Phone:817-547-0635
Mailing Address - Fax:
Practice Address - Street 1:5120 LEERAY RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-9233
Practice Address - Country:US
Practice Address - Phone:817-547-0635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty