Provider Demographics
NPI:1922821032
Name:ASSURED CHOICE
Entity type:Organization
Organization Name:ASSURED CHOICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:317-526-3161
Mailing Address - Street 1:28426 BUFFALO FORK LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2476
Mailing Address - Country:US
Mailing Address - Phone:317-526-3161
Mailing Address - Fax:
Practice Address - Street 1:28426 BUFFALO FORK LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2476
Practice Address - Country:US
Practice Address - Phone:317-526-3161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities