Provider Demographics
NPI:1629420864
Name:I CHOSE TO FLY
Entity Type:Organization
Organization Name:I CHOSE TO FLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:AFREKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-408-8045
Mailing Address - Street 1:8304 HARFORD RD
Mailing Address - Street 2:2ND FOOR
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234
Mailing Address - Country:US
Mailing Address - Phone:443-408-8045
Mailing Address - Fax:
Practice Address - Street 1:8304 HARFORD RD
Practice Address - Street 2:2ND FOOR
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-5700
Practice Address - Country:US
Practice Address - Phone:443-408-8045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities