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General NPI Number Information
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NPI Number | 1245371467
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Entity Type | Organization
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Legal Business Name | CHOICES FOR COMMUNITY LIVING INC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 43 LIBERTY DR
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City | AMSTERDAM
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State | NY
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Zip | 12010-5635
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Country | US
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Telephone | 518-842-5080
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Fax |
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Provider Business Mailing Address
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Address Line | 43 LIBERTY DR
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City | AMSTERDAM
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State | NY
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Zip | 12010-5635
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Country | US
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Telephone | 518-842-5080
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | KARL COTE
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Credential |
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Telephone | 518-954-3367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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Taxonomy #3
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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