Provider Demographics
NPI:1477160034
Name:CHOLET K JOSUE LLC
Entity Type:Organization
Organization Name:CHOLET K JOSUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHOLET
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:JOSUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-491-0183
Mailing Address - Street 1:8228 HARVEST BEND LN APT 14
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6150
Mailing Address - Country:US
Mailing Address - Phone:312-491-0183
Mailing Address - Fax:443-319-8691
Practice Address - Street 1:14201 LAUREL PARK DR STE 221
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5203
Practice Address - Country:US
Practice Address - Phone:443-885-0915
Practice Address - Fax:443-319-8691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty