Provider Demographics
NPI:1659745909
Name:CHOICES FOR RECOVERY, LLC
Entity Type:Organization
Organization Name:CHOICES FOR RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BURRELL
Authorized Official - Last Name:CRITTENDON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:704-969-4182
Mailing Address - Street 1:417C S. SHARON AMITY RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211
Mailing Address - Country:US
Mailing Address - Phone:704-969-4182
Mailing Address - Fax:704-365-4171
Practice Address - Street 1:200 QUEENS ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204
Practice Address - Country:US
Practice Address - Phone:704-969-4182
Practice Address - Fax:704-365-4171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health