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NPI Code Detail

MEDICARE: CHOOSING INDEPENDENCE INC

MEDICARE: CHOOSING INDEPENDENCE 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
1261QC1500XCommunity Health Clinic/Center

General Provider Information

NPI Number : 1518477157
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHOOSING INDEPENDENCE INC
Provider Business Mailing Address
First Line : 115 MARTIN LUTHER KING JR DR SW STE 225-102
Second Line :
City : ATLANTA
State : GA
Zip : 30303-3536
Country : US
Telephone Number : 404-829-2736
Fax Number :
Provider Business Practice Location Address
First Line : 115 MARTIN LUTHER KING JR DR SW STE 225-102
Second Line :
City : ATLANTA
State : GA
Zip : 30303-3536
Country : US
Telephone Number : 404-829-2736
Fax Number :
Authorized Official
Title or Position : ADMINISTRATION
Name : CHRISTIAN P RICHARDS JR.
Credential :
Telephone Number : 818-697-3357
Provider Enumeration Date : 10/10/2017
Last Update Date : 03/17/2018

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Directions to “CHOOSING INDEPENDENCE INC ” Practice Location

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