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General NPI Number Information
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NPI Number | 1518477157
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Entity Type | Organization
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Legal Business Name | CHOOSING INDEPENDENCE INC
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 115 MARTIN LUTHER KING JR DR SW STE 225-102
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City | ATLANTA
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State | GA
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Zip | 30303-3536
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Country | US
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Telephone | 404-829-2736
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Fax |
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Provider Business Mailing Address
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Address Line | 115 MARTIN LUTHER KING JR DR SW STE 225-102
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City | ATLANTA
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State | GA
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Zip | 30303-3536
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Country | US
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Telephone | 404-829-2736
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | CHRISTIAN P RICHARDS JR.
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Credential |
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Telephone | 818-697-3357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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