Provider Demographics
NPI:1205226404
Name:CHOICES BEHAVIORAL MENTAL HEALTH AND WELLNESS , LLC
Entity Type:Organization
Organization Name:CHOICES BEHAVIORAL MENTAL HEALTH AND WELLNESS , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-539-2481
Mailing Address - Street 1:4120 EVE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-1934
Mailing Address - Country:US
Mailing Address - Phone:844-239-3737
Mailing Address - Fax:
Practice Address - Street 1:4120 EVE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-1934
Practice Address - Country:US
Practice Address - Phone:844-239-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health