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General NPI Number Information
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NPI Number | 1386127363
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Entity Type | Organization
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Legal Business Name | CHOICE HEALTH CO LLC
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 315 W SOUTH BOULDER RD STE 109
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City | LOUISVILLE
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State | CO
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Zip | 80027-1157
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Country | US
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Telephone | 209-485-3365
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Fax |
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Provider Business Mailing Address
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Address Line | 315 W SOUTH BOULDER RD STE 109
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City | LOUISVILLE
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State | CO
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Zip | 80027-1157
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Country | US
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Telephone | 209-485-3365
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JORDAN R HAMILTON
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Credential | BA
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Telephone | 209-485-3365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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