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General NPI Number Information
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NPI Number | 1740799485
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Entity Type | Organization
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Legal Business Name | CHOOSE SUPPORT, LLC
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 12440 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-2628
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Country | US
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Telephone | 330-280-7749
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Fax |
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Provider Business Mailing Address
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Address Line | 4129 ORCHID DR
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City | HERNANDO BEACH
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State | FL
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Zip | 34607-3356
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Country | US
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Telephone | 330-280-7749
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL ZELIN
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Credential |
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Telephone | 330-280-7749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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