Provider Demographics
NPI:1174860076
Name:CHOSEN GENERATION COMMUNITY CENTER, INC.
Entity Type:Organization
Organization Name:CHOSEN GENERATION COMMUNITY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCPHATTER
Authorized Official - Suffix:
Authorized Official - Credentials:AAS
Authorized Official - Phone:910-224-4726
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:RED SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28377-0227
Mailing Address - Country:US
Mailing Address - Phone:910-224-4726
Mailing Address - Fax:
Practice Address - Street 1:808 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:RED SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28377-1527
Practice Address - Country:US
Practice Address - Phone:910-224-4726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable