Provider Demographics
NPI:1629780093
Name:ANOTHER CHOICE BEHAVIORAL HEALTH SERVICE
Entity Type:Organization
Organization Name:ANOTHER CHOICE BEHAVIORAL HEALTH SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYKESE
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-777-6132
Mailing Address - Street 1:5500 JOYCE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-2417
Mailing Address - Country:US
Mailing Address - Phone:980-213-9471
Mailing Address - Fax:
Practice Address - Street 1:2307 BOLDEN CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-1174
Practice Address - Country:US
Practice Address - Phone:704-777-6132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health