Healthcare Provider Details

I. General information

NPI: 1497190961
Provider Name (Legal Business Name): GUIDED CHOICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 05/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2812 N MARTIN LUTHER KING JR BLVD
LANSING MI
48906
US

IV. Provider business mailing address

2812 N MARTIN LUTHER KING JR BLVD
LANSING MI
48906
US

V. Phone/Fax

Practice location:
  • Phone: 517-999-2760
  • Fax: 517-999-2767
Mailing address:
  • Phone: 517-999-2760
  • Fax: 571-999-2767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number4704096532
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number6401000734
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELLEN ELIZABETH WEAVER
Title or Position: EXECUTIVE DIRECTOR
Credential: CRRN, CRC
Phone: 517-999-2760