Provider Demographics
NPI:1962671222
Name:COMMUNITY CHOICES, LLC
Entity Type:Organization
Organization Name:COMMUNITY CHOICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALIFIED PROFESSIONAL
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:COUSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-210-3774
Mailing Address - Street 1:3711 UNIVERSITY DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2654
Mailing Address - Country:US
Mailing Address - Phone:919-210-3774
Mailing Address - Fax:
Practice Address - Street 1:3711 UNIVERSITY DR
Practice Address - Street 2:SUITE C
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2654
Practice Address - Country:US
Practice Address - Phone:919-210-3774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health