Provider Demographics
NPI:1396360889
Name:YOUR CHOICE TREATMENT AND HEALTH
Entity Type:Organization
Organization Name:YOUR CHOICE TREATMENT AND HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JAMEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-300-6757
Mailing Address - Street 1:215 NAVAJO DR
Mailing Address - Street 2:
Mailing Address - City:RED LION
Mailing Address - State:PA
Mailing Address - Zip Code:17356-9646
Mailing Address - Country:US
Mailing Address - Phone:443-300-6757
Mailing Address - Fax:443-460-0865
Practice Address - Street 1:5430 CAMPBELL BLVD STE 107
Practice Address - Street 2:
Practice Address - City:WHITE MARSH
Practice Address - State:MD
Practice Address - Zip Code:21162-5503
Practice Address - Country:US
Practice Address - Phone:443-300-6757
Practice Address - Fax:443-460-0865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty