Provider Demographics
NPI:1457540361
Name:FIRST CHOICE COMMUNITY SERVICES INC.
Entity type:Organization
Organization Name:FIRST CHOICE COMMUNITY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:704-535-4342
Mailing Address - Street 1:5500 EXECUTIVE CENTER DR
Mailing Address - Street 2:STE 204
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8856
Mailing Address - Country:US
Mailing Address - Phone:704-535-4342
Mailing Address - Fax:704-535-4347
Practice Address - Street 1:5500 EXECUTIVE CENTER DR
Practice Address - Street 2:STE 204
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8856
Practice Address - Country:US
Practice Address - Phone:704-535-4342
Practice Address - Fax:704-535-4347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-060-1266385HR2060X
251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child