Provider Demographics
NPI:1952420614
Name:CHOICES FOR PEOPLE CENTER FOR CITIZENS WITH DISABILITIES INC
Entity Type:Organization
Organization Name:CHOICES FOR PEOPLE CENTER FOR CITIZENS WITH DISABILITIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT DAY HAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-426-5143
Mailing Address - Street 1:1840 E STATE HWY 72
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-3995
Mailing Address - Country:US
Mailing Address - Phone:573-364-7444
Mailing Address - Fax:573-364-5370
Practice Address - Street 1:704 HISTORIC RT 66 W
Practice Address - Street 2:SUITE 102
Practice Address - City:WAYNESVILLE
Practice Address - State:MO
Practice Address - Zip Code:65083
Practice Address - Country:US
Practice Address - Phone:573-774-4044
Practice Address - Fax:573-774-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO658261QA0600X
261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO295046502Medicaid