Provider Demographics
NPI:1932095619
Name:PREMIER CHOICE HOMES NFP CORP
Entity type:Organization
Organization Name:PREMIER CHOICE HOMES NFP CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:O
Authorized Official - Last Name:NOAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-221-1269
Mailing Address - Street 1:7260 W BENTON DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-9303
Mailing Address - Country:US
Mailing Address - Phone:708-564-9800
Mailing Address - Fax:708-810-9747
Practice Address - Street 1:7260 W BENTON DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-9303
Practice Address - Country:US
Practice Address - Phone:708-564-9800
Practice Address - Fax:708-810-9747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities