Provider Demographics
NPI:1598162216
Name:CHOICES IN LIVING COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:CHOICES IN LIVING COUNSELING CENTER, LLC
Other - Org Name:CHOICES COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLA
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRANGER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CACIII, NCACII,
Authorized Official - Phone:303-431-5664
Mailing Address - Street 1:4485 WADSWORTH BLVD
Mailing Address - Street 2:#206
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-3318
Mailing Address - Country:US
Mailing Address - Phone:303-431-5664
Mailing Address - Fax:303-431-6713
Practice Address - Street 1:4485 WADSWORTH BLVD
Practice Address - Street 2:#206
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-3318
Practice Address - Country:US
Practice Address - Phone:303-431-5664
Practice Address - Fax:303-431-6713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X
CO126500261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty