Provider Demographics
NPI:1205956307
Name:PK CHOICES, INC.
Entity type:Organization
Organization Name:PK CHOICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-882-3057
Mailing Address - Street 1:503 MOECKEL LN
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-4355
Mailing Address - Country:US
Mailing Address - Phone:912-882-3057
Mailing Address - Fax:912-882-7402
Practice Address - Street 1:503 MOECKEL LN
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-4355
Practice Address - Country:US
Practice Address - Phone:912-882-3057
Practice Address - Fax:912-882-7402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services