Provider Demographics
NPI:1841390630
Name:COMMUNITY CHOICES
Entity Type:Organization
Organization Name:COMMUNITY CHOICES
Other - Org Name:COMMUNITY CHOICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EDEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUSTIG
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:702-388-8805
Mailing Address - Street 1:3925 N. MARTIN LUTHER KING BLVD. #210
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032
Mailing Address - Country:US
Mailing Address - Phone:702-388-8805
Mailing Address - Fax:
Practice Address - Street 1:3925 N. MARTIN LUTHER KING BLVD. UNIT 201
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032
Practice Address - Country:US
Practice Address - Phone:702-388-8805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251V00000XAgenciesVoluntary or Charitable