Provider Demographics
NPI:1487911616
Name:1ST CHOICE SITTER SERVICE
Entity type:Organization
Organization Name:1ST CHOICE SITTER SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-630-8152
Mailing Address - Street 1:21130 GARDENIA ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70435-5927
Mailing Address - Country:US
Mailing Address - Phone:985-892-3137
Mailing Address - Fax:985-892-3137
Practice Address - Street 1:21130 GARDENIA ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70435-5927
Practice Address - Country:US
Practice Address - Phone:985-892-3137
Practice Address - Fax:985-892-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA94034528253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care