Healthcare Provider Details

I. General information

NPI: 1932889649
Provider Name (Legal Business Name): CHOICES SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 BEAUFONT SPRING DR STE 300
NORTH CHESTERFIELD VA
23225-5519
US

IV. Provider business mailing address

7400 BEAUFONT SPRING DR STE 300
NORTH CHESTERFIELD VA
23225-5519
US

V. Phone/Fax

Practice location:
  • Phone: 804-503-3389
  • Fax:
Mailing address:
  • Phone: 804-503-3389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: PORSCHA FAUSH
Title or Position: CEO
Credential:
Phone: 804-503-3389