Provider Demographics
NPI:1811259690
Name:NEW C.H.O.I.C.E.S., LLC
Entity type:Organization
Organization Name:NEW C.H.O.I.C.E.S., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEOLA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CSAC
Authorized Official - Phone:414-444-8445
Mailing Address - Street 1:3565 N. MARTIN LUTHER KING DRIVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1549
Mailing Address - Country:US
Mailing Address - Phone:414-444-8445
Mailing Address - Fax:414-444-8432
Practice Address - Street 1:3565 N. MARTIN LUTHER KING DRIVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-1549
Practice Address - Country:US
Practice Address - Phone:414-444-8445
Practice Address - Fax:414-444-8432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10883-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39175700Medicaid