Healthcare Provider Details

I. General information

NPI: 1508041252
Provider Name (Legal Business Name): CHILDRENS CHOICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 INTERNATIONAL PLAZA SUITE 325
PHILADELPHIA PA
19113-1511
US

IV. Provider business mailing address

2 INTERNATIONAL PLAZA SUITE 325
PHILADELPHIA PA
19113-1511
US

V. Phone/Fax

Practice location:
  • Phone: 610-521-6270
  • Fax: 610-521-6266
Mailing address:
  • Phone: 610-521-6270
  • Fax: 610-521-6266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StatePA

VIII. Authorized Official

Name: CAROLYN A EBERWEIN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 610-521-6270