Provider Demographics
NPI:1548240831
Name:FIRST CHOICE CHILDRENS HOMECARE LP
Entity type:Organization
Organization Name:FIRST CHOICE CHILDRENS HOMECARE LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-486-4100
Mailing Address - Street 1:101 EDGEWATER DRIVE, SUITE 110
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1262
Mailing Address - Country:US
Mailing Address - Phone:781-486-4100
Mailing Address - Fax:
Practice Address - Street 1:3415 GREYSTONE DR STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-2365
Practice Address - Country:US
Practice Address - Phone:512-828-3990
Practice Address - Fax:512-241-1277
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THRIVE SKILLED PEDIATRIC CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-20
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X, 385H00000X
TX017864251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174238901Medicaid
TX174238901Medicaid