Healthcare Provider Details

I. General information

NPI: 1063677722
Provider Name (Legal Business Name): CHOICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 10/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 MAIN STREET SUITE 1 VILLAGE DRIVE ESTATES
CORINTH ME
04427-0316
US

IV. Provider business mailing address

PO BOX 316
CORINTH ME
04427-0316
US

V. Phone/Fax

Practice location:
  • Phone: 207-285-0133
  • Fax: 207-285-0190
Mailing address:
  • Phone: 207-285-0133
  • Fax: 207-285-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number211962
License Number StateME

VIII. Authorized Official

Name: MR. LONNIE SCOTT PLANTE
Title or Position: ASSISTANT DIRECTOR
Credential:
Phone: 207-285-0133