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General NPI Number Information
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NPI Number | 1427824655
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Entity Type | Organization
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Legal Business Name | CHOSEN ENTERPRISES, LLC
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 1101 CALIFORNIA AVE STE 100-22
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City | CORONA
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State | CA
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Zip | 92881-6470
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Country | US
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Telephone | 951-582-2566
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Fax |
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Provider Business Mailing Address
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Address Line | 53205 TRAILING ROSE DR
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City | LAKE ELSINORE
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State | CA
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Zip | 92532-1661
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Country | US
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Telephone | 951-582-2566
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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 | SHEENA WALLACE
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Credential |
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Telephone | 310-488-7822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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