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Organization

CHOICES FOR LIFE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE CALLAHAN LSCSW (DIRECTOR OF ADMINISTRATION)
(913) 961-1719
Entity
Organization

Contact information

Practice address
2030 N 76TH TER, KANSAS CITY, KS 66109-2347
(913) 961-1719
Mailing address
11027 NORTHRIDGE DR, KANSAS CITY, KS 66109-4905
(913) 961-1719

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
3747P1801X
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200656440A
KS
Enumeration date
12/29/2011
Last updated
12/29/2011
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