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General NPI Number Information
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NPI Number | 1427432715
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE HEALTHCARE AND COUNSELING, LLC
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 608 S US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34950-8304
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Country | US
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Telephone | 772-216-6750
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Fax |
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Provider Business Mailing Address
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Address Line | 608 S US HIGHWAY 1
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City | FORT PIERCE
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State | FL
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Zip | 34950-8304
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Country | US
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Telephone | 772-216-6750
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. CASSANDRA HICKS
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Credential | ARNP
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Telephone | 772-216-6750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 9275760
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License Number State | FL
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