Healthcare Provider Details

I. General information

NPI: 1437759735
Provider Name (Legal Business Name): CHOICES INTEGRATED HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 05/10/2021
Certification Date: 04/13/2021
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 Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MR. FAHEEM NORFLEET
Title or Position: CO-OWNER/CFO
Credential:
Phone: 410-304-6670