Healthcare Provider Details

I. General information

NPI: 1215717392
Provider Name (Legal Business Name): FIRST CHOICE PERSONAL CARE AND LIVING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2023
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7429 CAMBERWOOD DR
INDIANAPOLIS IN
46268-4753
US

IV. Provider business mailing address

7429 CAMBERWOOD DR
INDIANAPOLIS IN
46268-4753
US

V. Phone/Fax

Practice location:
  • Phone: 317-508-7197
  • Fax:
Mailing address:
  • Phone: 317-508-7197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAI TAYLOR
Title or Position: OWNER
Credential: CCHW
Phone: 317-953-4310