Healthcare Provider Details

I. General information

NPI: 1457729741
Provider Name (Legal Business Name): RIGHT CHOICE HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 LIBERTY ST SUITE 205
SPRINGFIELD MA
01103-1114
US

IV. Provider business mailing address

125 LIBERTY ST SUITE 205
SPRINGFIELD MA
01103-1114
US

V. Phone/Fax

Practice location:
  • Phone: 413-271-7136
  • Fax: 413-271-7137
Mailing address:
  • Phone: 413-271-7136
  • Fax: 413-271-7137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number223674
License Number StateMA

VIII. Authorized Official

Name: DR. OMAR FARUK
Title or Position: CEO
Credential: MD
Phone: 413-271-7136