Healthcare Provider Details

I. General information

NPI: 1053996199
Provider Name (Legal Business Name): CHOICES INTEGRATED HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 - 1608 BUSH ST
BALTIMORE MD
21230-2021
US

IV. Provider business mailing address

1600 - 1608 BUSH ST
BALTIMORE MD
21230-2021
US

V. Phone/Fax

Practice location:
  • Phone: 410-304-6670
  • Fax: 410-304-6675
Mailing address:
  • Phone: 410-304-6670
  • Fax: 410-304-6675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY SMITH
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 410-304-6670