Healthcare Provider Details

I. General information

NPI: 1104719400
Provider Name (Legal Business Name): CHOICES HOUSE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 DELTONA BLVD STE 101
DELTONA FL
32725-8151
US

IV. Provider business mailing address

5224 W STATE ROAD 46 # 325
SANFORD FL
32771-9230
US

V. Phone/Fax

Practice location:
  • Phone: 386-215-5174
  • Fax: 888-558-2226
Mailing address:
  • Phone: 386-216-5174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: SHANNON THOMAS
Title or Position: CEO
Credential:
Phone: 386-259-4985