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General NPI Number Information
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NPI Number | 1932095619
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Entity Type | Organization
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Legal Business Name | PREMIER CHOICE HOMES NFP CORP
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 7260 W BENTON DR
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City | FRANKFORT
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State | IL
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Zip | 60423-9303
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Country | US
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Telephone | 708-564-9800
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Fax | 708-810-9747
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Provider Business Mailing Address
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Address Line | 7260 W BENTON DR
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City | FRANKFORT
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State | IL
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Zip | 60423-9303
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Country | US
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Telephone | 708-564-9800
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Fax | 708-810-9747
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | AISHA O NOAH
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Credential |
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Telephone | 312-221-1269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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