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General NPI Number Information
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NPI Number | 1821524059
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Entity Type | Organization
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Legal Business Name | CHOICES COORDINATED CARE SOLUTIONS, INC.
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Dates
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Enumeration Date | 05/09/2017
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Last Update Date | 05/09/2017
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Provider Practice Location Address
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Address Line | 30 W GUDE DR SUITE 270
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City | ROCKVILLE
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State | MD
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Zip | 20850-1161
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Country | US
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Telephone | 240-683-7300
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Fax | 240-683-7301
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Provider Business Mailing Address
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Address Line | 7941 CASTLEWAY DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-1953
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Country | US
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Telephone | 317-726-2121
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Fax | 866-849-3866
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MICHAEL GOLDBERG
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Credential |
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Telephone | 317-205-8202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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