Provider Demographics
NPI:1699026096
Name:CHOICES MENTAL HEALTH, INC.
Entity Type:Organization
Organization Name:CHOICES MENTAL HEALTH, INC.
Other - Org Name:CHOICES MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:COBB
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, BC
Authorized Official - Phone:386-279-0151
Mailing Address - Street 1:510 MANATEE SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-6442
Mailing Address - Country:US
Mailing Address - Phone:386-774-1380
Mailing Address - Fax:386-774-1380
Practice Address - Street 1:2239 S WOODLAND BLVD
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-8633
Practice Address - Country:US
Practice Address - Phone:386-279-0151
Practice Address - Fax:386-279-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health