Provider Demographics
NPI:1124454327
Name:ELDER CHOICE HEALTH CARE SERVICES, INC
Entity type:Organization
Organization Name:ELDER CHOICE HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:OSEMWENGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-966-9798
Mailing Address - Street 1:3231 CRYSTAL BROOK CT
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7453
Mailing Address - Country:US
Mailing Address - Phone:972-966-9798
Mailing Address - Fax:972-767-0907
Practice Address - Street 1:3231 CRYSTAL BROOK CT
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-7453
Practice Address - Country:US
Practice Address - Phone:972-966-9798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health