Organization
INDEPENDENT CHOICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LENORE FREDERICK (PRESIDENT)
(419) 732-0155
Entity
Organization
Contact information
Practice address
1854 E. PERRY ST., PORT CLINOTN, OH 43452
(419) 732-0155
(419) 732-0265
Mailing address
1854 E PERRY ST, PORT CLINTON, OH 43452-1578
(419) 732-0155
(419) 732-0265
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2026480
—
OH
Enumeration date
12/18/2009
Last updated
12/18/2009
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