Healthcare Provider Details

I. General information

NPI: 1194658583
Provider Name (Legal Business Name): 1ST CHOICE HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10320 SYCAMORE ST NW
COON RAPIDS MN
55433-4980
US

IV. Provider business mailing address

10320 SYCAMORE ST NW
COON RAPIDS MN
55433-4980
US

V. Phone/Fax

Practice location:
  • Phone: 651-214-3432
  • Fax:
Mailing address:
  • Phone: 651-214-3432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: BENJI BAO NGUYEN
Title or Position: OWNER
Credential:
Phone: 651-214-3432