Healthcare Provider Details
I. General information
NPI: 1952071979
Provider Name (Legal Business Name): MY CHOICE IN-HOME SENIOR CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2021
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3939 S HARVARD AVE STE 270
TULSA OK
74135-4654
US
IV. Provider business mailing address
3939 S HARVARD AVE STE 270
TULSA OK
74135-4654
US
V. Phone/Fax
- Phone: 918-728-6085
- Fax:
- Phone: 918-728-6085
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHERANNA
RAMEY
Title or Position: REGIONAL DIRECTOR
Credential:
Phone: 479-285-3060