Provider Demographics
NPI:1811539158
Name:CHOICES COORDINATED CARE SOLUTIONS, INC.
Entity Type:Organization
Organization Name:CHOICES COORDINATED CARE SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-517-6005
Mailing Address - Street 1:302 COURTHOUSE RD STE G
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-1890
Mailing Address - Country:US
Mailing Address - Phone:318-464-2561
Mailing Address - Fax:
Practice Address - Street 1:302 COURTHOUSE RD STE G
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-1890
Practice Address - Country:US
Practice Address - Phone:318-464-2561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHOICES COORDINATED CARE SOLUTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management