Provider Demographics
NPI:1679969885
Name:FIRST CHOICE QUALITY HEALTHCARE, INC
Entity type:Organization
Organization Name:FIRST CHOICE QUALITY HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:FATMATA
Authorized Official - Middle Name:
Authorized Official - Last Name:SACCOH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:240-553-7091
Mailing Address - Street 1:5010 SUNNYSIDE AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-2320
Mailing Address - Country:US
Mailing Address - Phone:240-553-7091
Mailing Address - Fax:240-553-7352
Practice Address - Street 1:5010 SUNNYSIDE AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2320
Practice Address - Country:US
Practice Address - Phone:240-553-7091
Practice Address - Fax:240-553-7352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3699251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR3699OtherLICENSE NUMBER R3699