Healthcare Provider Details

I. General information

NPI: 1386339968
Provider Name (Legal Business Name): ADVANCED CHOICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/10/2023
Certification Date: 04/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 US HIGHWAY 301
GARYSBURG NC
27831-9611
US

IV. Provider business mailing address

489 US HIGHWAY 301
GARYSBURG NC
27831-9611
US

V. Phone/Fax

Practice location:
  • Phone: 252-326-6732
  • Fax:
Mailing address:
  • Phone: 252-326-6732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. LESLIE GARNER
Title or Position: PRESIDENT
Credential:
Phone: 525-788-1862