Provider Demographics
NPI:1356752729
Name:MAKIN' CHOICES, INC.
Entity type:Organization
Organization Name:MAKIN' CHOICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS-BLUE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:910-483-2002
Mailing Address - Street 1:1076 STAMPER RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4191
Mailing Address - Country:US
Mailing Address - Phone:910-483-2002
Mailing Address - Fax:
Practice Address - Street 1:2215 E INDIANA AVE
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-7407
Practice Address - Country:US
Practice Address - Phone:910-603-4644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health