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Organization

CHOICE SUPPORTS COORDINATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL CHRISTOPHER HOLLERN (PRESIDENT)
(814) 812-0573
Entity
Organization

Contact information

Practice address
2312 W 15TH ST, ERIE, PA 16505-4560
(814) 812-0573
Mailing address
6200 LONGWOOD DR, ERIE, PA 16505-1023
(814) 812-0573

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary

Other

Enumeration date
06/16/2023
Last updated
06/16/2023
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