Provider Demographics
NPI:1881463610
Name:CHOSEN HOME CARE LLC
Entity type:Organization
Organization Name:CHOSEN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FELISA
Authorized Official - Middle Name:FANTASIA
Authorized Official - Last Name:EDNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-252-7189
Mailing Address - Street 1:486 PALMETTO RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-1217
Mailing Address - Country:US
Mailing Address - Phone:475-319-0427
Mailing Address - Fax:
Practice Address - Street 1:73 GOLDEN HILL ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4645
Practice Address - Country:US
Practice Address - Phone:475-319-0427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty