Provider Demographics
NPI:1760906374
Name:ANOTHER CHOICE ANOTHER CHANCE
Entity Type:Organization
Organization Name:ANOTHER CHOICE ANOTHER CHANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:STAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-388-9418
Mailing Address - Street 1:7000 FRANKLIN BLVD STE 625
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-1884
Mailing Address - Country:US
Mailing Address - Phone:916-388-9418
Mailing Address - Fax:916-388-9273
Practice Address - Street 1:3401 FONG RANCH RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1797
Practice Address - Country:US
Practice Address - Phone:916-388-9418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder