Provider Demographics
NPI:1942265640
Name:1ST CHOICE ENTERPRISES, INC.
Entity Type:Organization
Organization Name:1ST CHOICE ENTERPRISES, INC.
Other - Org Name:1ST CHOICE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-439-4757
Mailing Address - Street 1:101 KING PLZ
Mailing Address - Street 2:SUITE H
Mailing Address - City:COMMERCE
Mailing Address - State:TX
Mailing Address - Zip Code:75428-3735
Mailing Address - Country:US
Mailing Address - Phone:903-886-2666
Mailing Address - Fax:903-886-3773
Practice Address - Street 1:101 KING PLZ STE H
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428-3734
Practice Address - Country:US
Practice Address - Phone:903-886-2666
Practice Address - Fax:903-886-3773
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1ST CHOICE HOME HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-18
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX0010253943747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001025394Medicaid
TX677789Medicare ID - Type UnspecifiedPROVIDER NUMBER