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General NPI Number Information
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NPI Number | 1013287457
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Entity Type | Organization
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Legal Business Name | CHANGES OF CHOICE, INC.
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Dates
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Enumeration Date | 01/02/2012
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Last Update Date | 01/02/2012
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Provider Practice Location Address
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Address Line | 2223 STARLINE DR
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City | DECATUR
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State | GA
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Zip | 30032-5631
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Country | US
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Telephone | 404-328-1418
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Fax | 404-328-1499
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Provider Business Mailing Address
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Address Line | 2223 STARLINE DR
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City | DECATUR
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State | GA
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Zip | 30032-5631
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Country | US
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Telephone | 404-328-1418
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Fax | 404-328-1499
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Authorized Official
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Title or Position | CEO
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Name | MISS LANEDRA N MANNING
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Credential |
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Telephone | 404-328-1418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | GA
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