Provider Demographics
NPI:1982034039
Name:CHOICE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CHOICE HEALTH SERVICES, INC.
Other - Org Name:PRESTIGE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SQUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-608-5494
Mailing Address - Street 1:8036 S BURY RD
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84081-5148
Mailing Address - Country:US
Mailing Address - Phone:801-608-5494
Mailing Address - Fax:801-335-0523
Practice Address - Street 1:415 MEDICAL DR STE C101
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-8901
Practice Address - Country:US
Practice Address - Phone:801-335-0522
Practice Address - Fax:801-335-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health