Healthcare Provider Details

I. General information

NPI: 1881036796
Provider Name (Legal Business Name): MAKIN' CHOICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3828 GOFORTH DR
HOPE MILLS NC
28348-8502
US

IV. Provider business mailing address

107 DAVIS ST
FAYETTEVILLE NC
28305-5355
US

V. Phone/Fax

Practice location:
  • Phone: 910-527-0285
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
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: RACHELLE BROOKS - BLUE
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: LPC
Phone: 910-483-2002