MEDICARE: CHOSEN CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1326653890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHOSEN CARE, INC.

Provider Business Mailing Address
First Line	:	144 CLEMENS AVE
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-5613
Country	:	US
Telephone Number	:	830-455-0101
Fax Number	:

Provider Business Practice Location Address
First Line	:	5202 FOREST SPRINGS DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-3506
Country	:	US
Telephone Number	:	772-341-6847
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	ANGELA WHITE
Credential	:
Telephone Number	:	830-455-0101

Provider Enumeration Date	:	09/11/2020
Last Update Date	:	09/11/2020

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Directions to “CHOSEN CARE, INC. ” Practice Location

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