Healthcare Provider Details

I. General information

NPI: 1235777228
Provider Name (Legal Business Name): YOUR CHOICE OF HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2019
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 POST RD
WARWICK RI
02888-1548
US

IV. Provider business mailing address

15 BROOM ST
PROVIDENCE RI
02905-2901
US

V. Phone/Fax

Practice location:
  • Phone: 401-537-7849
  • Fax: 401-537-7815
Mailing address:
  • Phone: 401-537-7849
  • Fax: 401-537-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. EVELYN N PINTO DE DURAN
Title or Position: OWNER
Credential: RN
Phone: 401-499-3794