Provider Demographics
NPI:1235418641
Name:CHOICES BY DESIGN LLC
Entity Type:Organization
Organization Name:CHOICES BY DESIGN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:SHARAWN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:AUTHORIZED OFFICIAL
Authorized Official - Phone:763-493-5067
Mailing Address - Street 1:10650 COUNTY ROAD 81
Mailing Address - Street 2:SUITE 222A
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4075
Mailing Address - Country:US
Mailing Address - Phone:763-493-5067
Mailing Address - Fax:
Practice Address - Street 1:10650 COUNTY ROAD 81
Practice Address - Street 2:SUITE 222A
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4075
Practice Address - Country:US
Practice Address - Phone:763-493-5067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
MN362066251J00000X
MN1014217-4-RH253Z00000X
MN1019049-1-RH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN362066OtherCLASS A -PROFESSIONAL HOME CARE AGENCY
MNM120193000Medicaid
MNA620060000Medicaid