Provider Demographics
NPI:1831576917
Name:1ST CHOICE HOME CARE, LLC
Entity type:Organization
Organization Name:1ST CHOICE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WYATT-DEEM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:304-295-9789
Mailing Address - Street 1:PO BOX 373
Mailing Address - Street 2:
Mailing Address - City:LITTLE HOCKING
Mailing Address - State:OH
Mailing Address - Zip Code:45742-0373
Mailing Address - Country:US
Mailing Address - Phone:304-295-9789
Mailing Address - Fax:
Practice Address - Street 1:520 GRAND CENTRAL AVE
Practice Address - Street 2:SUITE 204B
Practice Address - City:VIENNA
Practice Address - State:WV
Practice Address - Zip Code:26105-2187
Practice Address - Country:US
Practice Address - Phone:304-295-9789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care