Provider Demographics
NPI:1942424072
Name:CHOICES SA MH INC
Entity type:Organization
Organization Name:CHOICES SA MH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCAS
Authorized Official - Phone:252-439-1886
Mailing Address - Street 1:601 COUNTRY CLUB DR STE A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6124
Mailing Address - Country:US
Mailing Address - Phone:252-439-1886
Mailing Address - Fax:252-695-0042
Practice Address - Street 1:601 COUNTRY CLUB DR STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6124
Practice Address - Country:US
Practice Address - Phone:252-439-1886
Practice Address - Fax:252-695-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL 074-162251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC605864Medicaid
NC6102862Medicaid
NC6111761Medicaid