Provider Demographics
NPI:1245619113
Name:CHOICES
Entity Type:Organization
Organization Name:CHOICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LUTHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:JONES
Authorized Official - Suffix:III
Authorized Official - Credentials:LICDC-S
Authorized Official - Phone:419-450-5735
Mailing Address - Street 1:5726 SOUTHWYCK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1510
Mailing Address - Country:US
Mailing Address - Phone:419-865-5690
Mailing Address - Fax:
Practice Address - Street 1:5726 SOUTHWYCK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1510
Practice Address - Country:US
Practice Address - Phone:419-865-5690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH913137251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health