Healthcare Provider Details

I. General information

NPI: 1225343783
Provider Name (Legal Business Name): CHOICES FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 12/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8929 DRIFTWOOD COMMONS CT
MINT HILL NC
28227-9751
US

IV. Provider business mailing address

8929 DRIFTWOOD COMMONS CT
MINT HILL NC
28227-9751
US

V. Phone/Fax

Practice location:
  • Phone: 980-339-9800
  • Fax:
Mailing address:
  • Phone: 980-339-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number20811819
License Number StateNC

VIII. Authorized Official

Name: CECIL LYNDELL DOWDELL JR.
Title or Position: DIRECTOR
Credential:
Phone: 980-339-9800