Healthcare Provider Details

I. General information

NPI: 1093394215
Provider Name (Legal Business Name): NEW CHOICE INTERVENTION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 E 154TH ST
HARVEY IL
60426-3326
US

IV. Provider business mailing address

142 E 154TH ST
HARVEY IL
60426-3326
US

V. Phone/Fax

Practice location:
  • Phone: 708-566-1768
  • Fax: 708-566-1786
Mailing address:
  • Phone: 708-566-1768
  • Fax: 708-566-1786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. TUNDE O ALI
Title or Position: PRESIDENT/CEO
Credential: PHD, ACSW, QIDP, EIS
Phone: 708-566-1768