Provider Demographics
NPI:1477930469
Name:CHOICES FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:CHOICES FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HAIRSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-403-4740
Mailing Address - Street 1:133 E. MARKET STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-3740
Mailing Address - Country:US
Mailing Address - Phone:276-403-4740
Mailing Address - Fax:
Practice Address - Street 1:133 E MARKET ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-3738
Practice Address - Country:US
Practice Address - Phone:276-403-4740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty