Provider Demographics
NPI:1104165703
Name:FIRST CHOICE COMPANION SERVICE, LLC
Entity type:Organization
Organization Name:FIRST CHOICE COMPANION SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:QMHP
Authorized Official - Phone:757-303-0572
Mailing Address - Street 1:709 AUSTIN COURT
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23605
Mailing Address - Country:US
Mailing Address - Phone:757-303-0572
Mailing Address - Fax:
Practice Address - Street 1:709 AUSTIN COURT
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23605
Practice Address - Country:US
Practice Address - Phone:757-303-0572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care