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General NPI Number Information
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NPI Number | 1508911348
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Entity Type | Organization
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Legal Business Name | COMMUNITY CHOICE, INCORPORATED
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9609 NEWFOUNDLAND CIR
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City | AUSTIN
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State | TX
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Zip | 78758-6207
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Country | US
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Telephone | 512-835-8955
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Fax |
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Provider Business Mailing Address
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Address Line | 9609 NEWFOUNDLAND CIR
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City | AUSTIN
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State | TX
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Zip | 78758-6207
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | THOMAS CONROY
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Credential |
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Telephone | 512-835-8955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | TX
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