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General NPI Number Information
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NPI Number | 1770942096
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Entity Type | Organization
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Legal Business Name | 1ST CHOICE TREATMENT, LC
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 16124 MOROSS RD
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City | DETROIT
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State | MI
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Zip | 48205-2566
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Country | US
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Telephone | 313-521-0180
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Fax |
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Provider Business Mailing Address
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Address Line | 48093 KINGS CT
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City | MACOMB
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State | MI
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Zip | 48044-6500
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Country | US
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Telephone | 313-617-6805
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CHIQUITA CARTER
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Credential |
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Telephone | 313-521-0180
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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 |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801064578
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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