Provider Demographics
NPI:1265771604
Name:CHOICES RECOVERY SERVICES, LLC
Entity type:Organization
Organization Name:CHOICES RECOVERY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BYUS
Authorized Official - Suffix:
Authorized Official - Credentials:MAC, CADC III
Authorized Official - Phone:541-504-7535
Mailing Address - Street 1:PO BOX 2298
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-0470
Mailing Address - Country:US
Mailing Address - Phone:541-504-7535
Mailing Address - Fax:541-504-7535
Practice Address - Street 1:357 NE COURT ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1936
Practice Address - Country:US
Practice Address - Phone:541-504-7535
Practice Address - Fax:541-504-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 175T00000X, 261QR0405X
OR1543364-8251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500662204Medicaid
OR500772430Medicaid
OR500654390Medicaid
OR278974Medicaid
OR500743475Medicaid
OR500770685Medicaid
OR500779958Medicaid
OR500771685Medicaid
OR500210831Medicaid