Provider Demographics
NPI:1053583732
Name:FIRST CHOICE REHABILITATION CENTER INC
Entity type:Organization
Organization Name:FIRST CHOICE REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:G
Authorized Official - Last Name:KHRAKOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-730-9555
Mailing Address - Street 1:215 A HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134
Mailing Address - Country:US
Mailing Address - Phone:617-730-9555
Mailing Address - Fax:617-413-9850
Practice Address - Street 1:215 A HARVARD AVE
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134
Practice Address - Country:US
Practice Address - Phone:617-730-9555
Practice Address - Fax:617-730-4555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2619111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty