Provider Demographics
NPI:1760262679
Name:STAR CHOICES, INC.
Entity Type:Organization
Organization Name:STAR CHOICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MARIENELA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVELAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-828-9011
Mailing Address - Street 1:1285 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1615
Mailing Address - Country:US
Mailing Address - Phone:784-743-9801
Mailing Address - Fax:478-223-4445
Practice Address - Street 1:1285 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1615
Practice Address - Country:US
Practice Address - Phone:784-743-9801
Practice Address - Fax:478-223-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities