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General NPI Number Information
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NPI Number | 1457540361
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE COMMUNITY SERVICES INC.
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 5500 EXECUTIVE CENTER DR STE 204
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City | CHARLOTTE
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State | NC
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Zip | 28212-8856
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Country | US
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Telephone | 704-535-4342
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Fax | 704-535-4347
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Provider Business Mailing Address
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Address Line | 5500 EXECUTIVE CENTER DR STE 204
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City | CHARLOTTE
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State | NC
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Zip | 28212-8856
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Country | US
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Telephone | 704-535-4342
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Fax | 704-535-4347
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LISA BROWN-SMITH
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Credential | M.ED.
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Telephone | 704-535-4342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number | MHL-060-1266
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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