=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962307157
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHOSEN FAMILY SERVICES LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2026
-----------------------------------------------------
Last Update Date | 10/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 207 W MAIN ST # S104
-----------------------------------------------------
City | MOORESTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08057-2325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-640-3885
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 230 N MAPLE AVE STE B1
-----------------------------------------------------
City | MARLTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08053-9412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-813-7643
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. KIMBERLY SMITH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 856-813-7643
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------