Provider Demographics
NPI:1972113595
Name:YOUR CHOICE ENTERPRISES LLC
Entity Type:Organization
Organization Name:YOUR CHOICE ENTERPRISES LLC
Other - Org Name:YOUR CHOICE WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIONNEDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTHERN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:281-382-9992
Mailing Address - Street 1:16635 SPRING CYPRESS RD # 1846
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-9998
Mailing Address - Country:US
Mailing Address - Phone:281-382-9992
Mailing Address - Fax:
Practice Address - Street 1:11104 W AIRPORT BLVD STE 110
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3016
Practice Address - Country:US
Practice Address - Phone:281-980-3328
Practice Address - Fax:281-676-5089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-07
Last Update Date:2023-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty