Provider Demographics
NPI:1952540916
Name:2 SISTERS PCA CHOICE HOME CARE, INC
Entity Type:Organization
Organization Name:2 SISTERS PCA CHOICE HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-247-4339
Mailing Address - Street 1:500 HIGHWAY 96 W STE 100
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-1959
Mailing Address - Country:US
Mailing Address - Phone:651-247-4339
Mailing Address - Fax:
Practice Address - Street 1:500 HIGHWAY 96 W STE 100
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-1959
Practice Address - Country:US
Practice Address - Phone:651-247-4339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-16
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health