Provider Demographics
NPI:1891373874
Name:CHOICES INTEGRATED HEALTHCARE
Entity Type:Organization
Organization Name:CHOICES INTEGRATED HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-304-6670
Mailing Address - Street 1:1600 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-2021
Mailing Address - Country:US
Mailing Address - Phone:410-304-6670
Mailing Address - Fax:410-304-6675
Practice Address - Street 1:1600 BUSH ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-2021
Practice Address - Country:US
Practice Address - Phone:410-304-6670
Practice Address - Fax:410-304-6675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD200910121OtherLEVEL 2.1 INTENSIVE OUTPATIENT TREATMENT PROGRAM