Provider Demographics
NPI:1407129653
Name:YOUR CHOICE HOME HEALTH SERVICES INC
Entity type:Organization
Organization Name:YOUR CHOICE HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MAZAK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:419-961-6865
Mailing Address - Street 1:2230 VILLAGE MALL DR STE 600
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4025
Mailing Address - Country:US
Mailing Address - Phone:567-333-0621
Mailing Address - Fax:567-429-2900
Practice Address - Street 1:2230 VILLAGE MALL DR STE 600
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-4025
Practice Address - Country:US
Practice Address - Phone:567-333-0621
Practice Address - Fax:567-429-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2021212251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health