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General NPI Number Information
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NPI Number | 1528409091
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Entity Type | Organization
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Legal Business Name | MY CHOICE SENIOR SERVICES
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 31610 STE 4 RAILROAD CANYON RD
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City | CANYON LAKE
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State | CA
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Zip | 92587-9454
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Country | US
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Telephone | 951-695-2306
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Fax |
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Provider Business Mailing Address
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Address Line | 31610 STE 4 RAILROAD CANYON RD
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City | CANYON LAKE
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State | CA
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Zip | 92587-9454
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Country | US
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Telephone | 951-695-2306
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. MEGAN E WALTON
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Credential | BS
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Telephone | 951-695-2306
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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 | 0893
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License Number State | CA
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