Provider Demographics
NPI:1619374576
Name:YOUR CHOICE SERVICES, INC.
Entity Type:Organization
Organization Name:YOUR CHOICE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST TREAS
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MONDRAGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-889-0018
Mailing Address - Street 1:3824 BARRETT DR
Mailing Address - Street 2:STE 105
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7220
Mailing Address - Country:US
Mailing Address - Phone:919-787-7423
Mailing Address - Fax:
Practice Address - Street 1:6737 SIX FORKS RD
Practice Address - Street 2:B2
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6423
Practice Address - Country:US
Practice Address - Phone:919-787-7423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services