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General NPI Number Information
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NPI Number | 1194190942
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Entity Type | Organization
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Legal Business Name | CHOICES UNLIMITED, INC.
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Dates
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Enumeration Date | 12/04/2015
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 3474 SE HILL RD
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City | MILWAUKIE
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State | OR
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Zip | 97267-1571
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Country | US
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Telephone | 503-786-6211
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1714
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City | GRESHAM
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State | OR
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Zip | 97030-0533
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Country | US
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Telephone | 503-936-2818
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MANUELA CHRISTINA MANN
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Credential | RN
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Telephone | 503-936-2818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 090000627RN
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License Number State | OR
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