Provider Demographics
NPI:1346223781
Name:CHOICES OF LONG BEACH INC
Entity Type:Organization
Organization Name:CHOICES OF LONG BEACH INC
Other - Org Name:CHOICES RECOVERY SERVICES, CHOICES TREATMENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZULLO
Authorized Official - Suffix:
Authorized Official - Credentials:NCRS CPRP CCDC COADC
Authorized Official - Phone:562-590-9010
Mailing Address - Street 1:PO BOX 40119
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-6119
Mailing Address - Country:US
Mailing Address - Phone:562-590-9010
Mailing Address - Fax:562-590-8045
Practice Address - Street 1:1601 E 10TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-5035
Practice Address - Country:US
Practice Address - Phone:562-590-9010
Practice Address - Fax:562-590-8045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA198600681320800000X, 323P00000X
CA190487BP324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility