Provider Demographics
NPI:1003351610
Name:CARE CHOICE HEALTH SYSTEMS, INC.
Entity type:Organization
Organization Name:CARE CHOICE HEALTH SYSTEMS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:IZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-798-4508
Mailing Address - Street 1:1151 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-7228
Mailing Address - Country:US
Mailing Address - Phone:760-405-1505
Mailing Address - Fax:760-798-4519
Practice Address - Street 1:1151 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-7228
Practice Address - Country:US
Practice Address - Phone:760-405-1505
Practice Address - Fax:760-798-4519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 372600000X, 385H00000X, 253Z00000X, 251S00000X
CA374700059253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA374700059OtherDEPARTMENT OF SOCIAL SERVICES