Provider Demographics
NPI:1407186331
Name:CHOICES OF CHANGE LLC
Entity Type:Organization
Organization Name:CHOICES OF CHANGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:CHERRY
Authorized Official - Last Name:SHIVER
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:478-290-5770
Mailing Address - Street 1:7 CANE GRINDER CT
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-9452
Mailing Address - Country:US
Mailing Address - Phone:478-290-5770
Mailing Address - Fax:912-921-5186
Practice Address - Street 1:7 CANE GRINDER CT
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-9452
Practice Address - Country:US
Practice Address - Phone:478-290-5770
Practice Address - Fax:912-921-5186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-26
Last Update Date:2009-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services