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General NPI Number Information
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NPI Number | 1477353613
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Entity Type | Organization
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Legal Business Name | CHOSEN GENERATION COMMUNITY CARE LLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 2442 HODGES BEND CIR
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City | SUGAR LAND
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State | TX
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Zip | 77479-1301
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Country | US
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Telephone | 346-422-7409
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Fax |
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Provider Business Mailing Address
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Address Line | 2442 HODGES BEND CIR
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City | SUGAR LAND
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State | TX
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Zip | 77479-1301
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Country | US
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Telephone | 346-422-7409
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KHAYLA FIELDS
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Credential | CHW
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Telephone | 346-422-7409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | NULL
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