Provider Demographics
NPI:1215358494
Name:FAMILY CHOICE LLC
Entity Type:Organization
Organization Name:FAMILY CHOICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:NATHANIEL
Authorized Official - Last Name:BARNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-702-3568
Mailing Address - Street 1:530 S 2ND ST
Mailing Address - Street 2:APT. 528
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2420
Mailing Address - Country:US
Mailing Address - Phone:267-702-3568
Mailing Address - Fax:
Practice Address - Street 1:530 S 2ND ST
Practice Address - Street 2:APT. 528
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-2420
Practice Address - Country:US
Practice Address - Phone:267-702-3568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-14
Last Update Date:2013-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health