Healthcare Provider Details

I. General information

NPI: 1760304588
Provider Name (Legal Business Name): CHOICE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4113 N 100TH ST
MILWAUKEE WI
53222-1311
US

IV. Provider business mailing address

4113 N 100TH ST
MILWAUKEE WI
53222-1311
US

V. Phone/Fax

Practice location:
  • Phone: 414-499-5765
  • Fax: 414-499-5765
Mailing address:
  • Phone: 414-499-5765
  • Fax: 414-499-5765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TIA LYZETTA-MARIE SANDERS
Title or Position: OWNER
Credential: MS, LPC, SAC-IT
Phone: 414-499-5765