MEDICARE: ANOTHER CHOICE, ANOTHER CHANCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	3432	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871771626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANOTHER CHOICE, ANOTHER CHANCE

Provider Business Mailing Address
First Line	:	7000 FRANKLIN BLVD STE 625
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-1884
Country	:	US
Telephone Number	:	916-388-9418
Fax Number	:	916-388-9273

Provider Business Practice Location Address
First Line	:	2040 ETHAN WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-0118
Country	:	US
Telephone Number	:	916-566-2051
Fax Number	:

Authorized Official
Title or Position	:	PROGRAMS MANAGER/DIRECTOR
Name	:	MS. STAR CANNON
Credential	:	CADC II
Telephone Number	:	916-388-9418

Provider Enumeration Date	:	02/04/2008
Last Update Date	:	07/17/2014

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Directions to “ANOTHER CHOICE, ANOTHER CHANCE ” Practice Location

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