Healthcare Provider Details

I. General information

NPI: 1255691028
Provider Name (Legal Business Name): CHOICES NETWORK SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2012
Last Update Date: 05/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 NW 6TH ST
POMPANO BEACH FL
33069-2214
US

IV. Provider business mailing address

2300 NW 6TH ST
POMPANO BEACH FL
33069-2214
US

V. Phone/Fax

Practice location:
  • Phone: 954-968-6777
  • Fax: 954-968-6633
Mailing address:
  • Phone: 954-968-6777
  • Fax: 954-968-6633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number100012645
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number100012645
License Number StateFL

VIII. Authorized Official

Name: MR. WYLIE L HOWARD SR.
Title or Position: FOUNDER/CEO
Credential:
Phone: 954-968-6777