Provider Demographics
NPI:1457958878
Name:YOUR CHOICE SENIOR CARE FAIRHOPE, LLC
Entity Type:Organization
Organization Name:YOUR CHOICE SENIOR CARE FAIRHOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-729-9303
Mailing Address - Street 1:21883 STATE HIGHWAY 181
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-5286
Mailing Address - Country:US
Mailing Address - Phone:251-599-8101
Mailing Address - Fax:251-217-8106
Practice Address - Street 1:21883 STATE HIGHWAY 181
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-5286
Practice Address - Country:US
Practice Address - Phone:251-599-8101
Practice Address - Fax:251-217-8106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty