Healthcare Provider Details

I. General information

NPI: 1295125367
Provider Name (Legal Business Name): FIRST CHOICE HOME & COMMUNITY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 01/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 PUSEY AVE SUITE 230
COLLINGDALE PA
19023-3300
US

IV. Provider business mailing address

520 PUSEY AVE SUITE 230
COLLINGDALE PA
19023-3300
US

V. Phone/Fax

Practice location:
  • Phone: 610-200-4299
  • Fax:
Mailing address:
  • Phone: 610-200-4299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: ABDULIA TALL
Title or Position: PRESIDENT/CEO
Credential: MPA
Phone: 610-200-4299