Provider Demographics
NPI:1700097433
Name:HOME CHOICE SR CARE
Entity Type:Organization
Organization Name:HOME CHOICE SR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:OUELLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:CED
Authorized Official - Phone:203-227-5040
Mailing Address - Street 1:21 CHARLES ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5803
Mailing Address - Country:US
Mailing Address - Phone:203-227-5040
Mailing Address - Fax:
Practice Address - Street 1:21 CHARLES ST
Practice Address - Street 2:SUITE 212
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5803
Practice Address - Country:US
Practice Address - Phone:203-227-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty