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General NPI Number Information
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NPI Number | 1942424072
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Entity Type | Organization
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Legal Business Name | CHOICES SA MH INC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 01/06/2010
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Provider Practice Location Address
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Address Line | 601 COUNTRY CLUB DR STE A
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City | GREENVILLE
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State | NC
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Zip | 27834-6124
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Country | US
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Telephone | 252-439-1886
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Fax | 252-695-0042
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Provider Business Mailing Address
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Address Line | 601 COUNTRY CLUB DR STE A
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City | GREENVILLE
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State | NC
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Zip | 27834-6124
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Country | US
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Telephone | 252-439-1886
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Fax | 252-695-0042
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MISS BARBARA HESTER
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Credential | LPC, LCAS
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Telephone | 252-439-1886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL 074-162
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License Number State | NC
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