Provider Demographics
NPI:1114243912
Name:CHOSEN ASSOCIATES
Entity Type:Organization
Organization Name:CHOSEN ASSOCIATES
Other - Org Name:AGC COMMUNITY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-943-6229
Mailing Address - Street 1:560 DABNEY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-3946
Mailing Address - Country:US
Mailing Address - Phone:252-433-0255
Mailing Address - Fax:
Practice Address - Street 1:560 DABNEY DR
Practice Address - Street 2:SUITE B
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-3946
Practice Address - Country:US
Practice Address - Phone:252-433-0255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health