Provider Demographics
NPI:1962791426
Name:FAMILY CHOICE HOME CARE
Entity type:Organization
Organization Name:FAMILY CHOICE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STOLZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-219-8259
Mailing Address - Street 1:120 BRIGHT LEAF DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-7301
Mailing Address - Country:US
Mailing Address - Phone:606-219-8259
Mailing Address - Fax:
Practice Address - Street 1:120 BRIGHT LEAF DR.
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503
Practice Address - Country:US
Practice Address - Phone:606-219-8259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-A3295310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility