Provider Demographics
NPI:1376051003
Name:GOOD CHOICE TEAM, LLC.
Entity Type:Organization
Organization Name:GOOD CHOICE TEAM, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:
Authorized Official - Last Name:BONET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-970-8062
Mailing Address - Street 1:560 VILLAGE BLVD STE 325
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1962
Mailing Address - Country:US
Mailing Address - Phone:561-771-9561
Mailing Address - Fax:800-766-3139
Practice Address - Street 1:560 VILLAGE BLVD STE 325
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1962
Practice Address - Country:US
Practice Address - Phone:561-771-9561
Practice Address - Fax:800-766-3139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty