Provider Demographics
NPI:1902380017
Name:CHOICE RECOVERY COACHING INC.
Entity Type:Organization
Organization Name:CHOICE RECOVERY COACHING INC.
Other - Org Name:CHOICE RECOVERY COACHING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/PROGRAM DIRECTOR/PEER SUPER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALVES
Authorized Official - Suffix:
Authorized Official - Credentials:CARC, NCPRSS
Authorized Official - Phone:413-272-8520
Mailing Address - Street 1:155 MAPLE ST.
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01105
Mailing Address - Country:US
Mailing Address - Phone:413-272-8520
Mailing Address - Fax:413-256-1181
Practice Address - Street 1:155 MAPLE ST.
Practice Address - Street 2:SUITE 305
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105
Practice Address - Country:US
Practice Address - Phone:413-272-8520
Practice Address - Fax:413-256-1181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty