Provider Demographics
NPI:1720342025
Name:FIRST CHOICE CHILDREN'S HOMECARE, LP
Entity Type:Organization
Organization Name:FIRST CHOICE CHILDREN'S HOMECARE, LP
Other - Org Name:THRIVE SKILLED PEDIATRIC CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-486-4100
Mailing Address - Street 1:101 EDGEWATER DRIVE, SUITE 110
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1262
Mailing Address - Country:US
Mailing Address - Phone:781-486-4100
Mailing Address - Fax:
Practice Address - Street 1:1303 82ND STREET, SUITE 800
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2388
Practice Address - Country:US
Practice Address - Phone:806-687-3124
Practice Address - Fax:806-687-3358
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THRIVE SKILLED PEDIATRIC CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-02
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017836251E00000X
251J00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX305718401Medicaid