Healthcare Provider Details
I. General information
NPI: 1699026096
Provider Name (Legal Business Name): CHOICES MENTAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2012
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2239 S WOODLAND BLVD
DELAND FL
32720-8633
US
IV. Provider business mailing address
510 MANATEE SPRINGS CT
ORANGE CITY FL
32763-6442
US
V. Phone/Fax
- Phone: 386-279-0151
- Fax: 386-279-0148
- Phone: 386-774-1380
- Fax: 386-774-1380
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CAROLYN
COBB
STEWART
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: ARNP, BC
Phone: 386-279-0151