Provider Demographics
NPI:1669182374
Name:CHOICECARE IN-HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:CHOICECARE IN-HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:CNA, CHPNA
Authorized Official - Phone:231-525-2299
Mailing Address - Street 1:1331 S WALKER RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-4553
Mailing Address - Country:US
Mailing Address - Phone:231-525-2299
Mailing Address - Fax:231-777-8125
Practice Address - Street 1:1331 S WALKER RD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-4553
Practice Address - Country:US
Practice Address - Phone:231-525-2299
Practice Address - Fax:231-777-8125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care