Provider Demographics
NPI:1013155159
Name:SENIORS FIRST CHOICE INC
Entity type:Organization
Organization Name:SENIORS FIRST CHOICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:THERESE
Authorized Official - Last Name:TAGGART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-888-6753
Mailing Address - Street 1:9810A MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2016
Mailing Address - Country:US
Mailing Address - Phone:770-888-6753
Mailing Address - Fax:770-817-1054
Practice Address - Street 1:9810A MEDLOCK BRIDGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-2016
Practice Address - Country:US
Practice Address - Phone:770-888-6753
Practice Address - Fax:770-817-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058-R-0010253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care