Provider Demographics
NPI:1407803034
Name:CHILDREN'S CHOICE
Entity Type:Organization
Organization Name:CHILDREN'S CHOICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-880-3887
Mailing Address - Street 1:1813 SWEETBAY DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-1663
Mailing Address - Country:US
Mailing Address - Phone:410-546-6106
Mailing Address - Fax:410-219-2640
Practice Address - Street 1:1813 SWEETBAY DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1663
Practice Address - Country:US
Practice Address - Phone:410-546-6106
Practice Address - Fax:410-219-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD144304600Medicaid