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NPI Code Detail

MEDICARE: CHOICES SUPPORT SERVICES, LLC

MEDICARE: CHOICES SUPPORT SERVICES, LLC
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
1171WH0202XHome Modifications Contractor
2251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1932889649
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHOICES SUPPORT SERVICES, LLC
Provider Business Mailing Address
First Line : 7400 BEAUFONT SPRING DR STE 300
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23225-5519
Country : US
Telephone Number : 804-503-3389
Fax Number :
Provider Business Practice Location Address
First Line : 7400 BEAUFONT SPRING DR STE 300
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23225-5519
Country : US
Telephone Number : 804-503-3389
Fax Number :
Authorized Official
Title or Position : CEO
Name : PORSCHA FAUSH
Credential :
Telephone Number : 804-503-3389
Provider Enumeration Date : 07/19/2023
Last Update Date : 07/19/2023

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