Provider Demographics
NPI:1871708404
Name:CHOICE CARE SERVICES, INC.
Entity type:Organization
Organization Name:CHOICE CARE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TASSIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCDANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:313-510-1625
Mailing Address - Street 1:2711 E JEFFERSON AVE
Mailing Address - Street 2:201
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-4105
Mailing Address - Country:US
Mailing Address - Phone:313-510-1625
Mailing Address - Fax:313-885-7790
Practice Address - Street 1:4867 AUDUBON RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2754
Practice Address - Country:US
Practice Address - Phone:313-510-1625
Practice Address - Fax:313-885-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6947086Medicaid