Provider Demographics
NPI:1518477157
Name:CHOOSING INDEPENDENCE INC
Entity Type:Organization
Organization Name:CHOOSING INDEPENDENCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:818-697-3357
Mailing Address - Street 1:115 MARTIN LUTHER KING JR DR SW STE 225-102
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3536
Mailing Address - Country:US
Mailing Address - Phone:404-829-2736
Mailing Address - Fax:
Practice Address - Street 1:115 MARTIN LUTHER KING JR DR SW STE 225-102
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3536
Practice Address - Country:US
Practice Address - Phone:404-829-2736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health