Provider Demographics
NPI:1790968865
Name:FAMILY CHOICE HOME CARE
Entity Type:Organization
Organization Name:FAMILY CHOICE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CHIEF NURSING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:612-354-5747
Mailing Address - Street 1:2486 POND CIR W
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55120-1939
Mailing Address - Country:US
Mailing Address - Phone:612-354-5747
Mailing Address - Fax:844-254-1239
Practice Address - Street 1:2486 POND CIR W
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1939
Practice Address - Country:US
Practice Address - Phone:651-452-5298
Practice Address - Fax:651-452-5298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health