Provider Demographics
NPI:1942363072
Name:CHOICES RECOVERY CENTER INC.
Entity Type:Organization
Organization Name:CHOICES RECOVERY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:AGNOLUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-460-5053
Mailing Address - Street 1:606 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-3096
Mailing Address - Country:US
Mailing Address - Phone:772-460-5053
Mailing Address - Fax:772-460-5054
Practice Address - Street 1:606 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-3096
Practice Address - Country:US
Practice Address - Phone:772-460-5053
Practice Address - Fax:772-460-5054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15-56-AD-1597-00324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility