Provider Demographics
NPI:1013660950
Name:CHOICE TBI SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:CHOICE TBI SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORMSBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-279-4180
Mailing Address - Street 1:23 JONES BROTHERS WAY
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-2527
Mailing Address - Country:US
Mailing Address - Phone:802-622-8122
Mailing Address - Fax:802-622-8125
Practice Address - Street 1:23 JONES BROTHERS WAY
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-2527
Practice Address - Country:US
Practice Address - Phone:802-622-8122
Practice Address - Fax:802-622-8125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT047W339Medicaid
VT047W403Medicaid
VT1017489Medicaid