Organization
YOUR CHOICE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W GIBSON SR. (VP/TREASURER)
(919) 889-0012
Entity
Organization
Contact information
Practice address
1035 BRISTOE DR, APT 107, KNIGHTDALE, NC 27545-6459
(919) 787-7423
(919) 786-4948
Mailing address
3824 BARRETT DR, STE 105, RALEIGH, NC 27609-7220
(919) 787-7423
(919) 786-4948
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
MHL092673
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659497154
—
NC
Enumeration date
11/15/2013
Last updated
11/15/2013
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