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General NPI Number Information
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NPI Number | 1962791426
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Entity Type | Organization
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Legal Business Name | FAMILY CHOICE HOME CARE
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 04/05/2011
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Provider Practice Location Address
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Address Line | 120 BRIGHT LEAF DR.
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City | SOMERSET
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State | KY
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Zip | 42503
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Country | US
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Telephone | 606-219-8259
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Fax |
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Provider Business Mailing Address
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Address Line | 120 BRIGHT LEAF DR
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City | SOMERSET
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State | KY
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Zip | 42503-7301
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Country | US
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Telephone | 606-219-8259
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPY ASSISTANT
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Name | LISA MARIE STOLZE
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Credential |
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Telephone | 606-219-8259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | KY-A3295
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License Number State | KY
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