Provider Demographics
NPI:1760671861
Name:COMMUNITY CHOICE, INC.
Entity Type:Organization
Organization Name:COMMUNITY CHOICE, INC.
Other - Org Name:COMMUNITY CHOICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-756-3397
Mailing Address - Street 1:4218 ROANOKE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-4983
Mailing Address - Country:US
Mailing Address - Phone:816-756-3397
Mailing Address - Fax:816-756-3320
Practice Address - Street 1:4218 ROANOKE RD STE 210
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-4983
Practice Address - Country:US
Practice Address - Phone:816-756-3397
Practice Address - Fax:816-756-3320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO320900000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385H00000XRespite Care FacilityRespite Care