Healthcare Provider Details

I. General information

NPI: 1851599898
Provider Name (Legal Business Name): CHOICES UNLIMITED INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 HARRISON RD
BENTON KY
42025-5614
US

IV. Provider business mailing address

990 HARRISON RD
BENTON KY
42025-5614
US

V. Phone/Fax

Practice location:
  • Phone: 270-703-9117
  • Fax:
Mailing address:
  • Phone: 270-703-9117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. LARRY MORGAN
Title or Position: EXECUTIVE DIRECTOR
Credential: LSW
Phone: 270-703-9117