Organization
CHOICE PROVIDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY CRAIGH STAFFORD (CO-OWNER)
(318) 704-6591
Entity
Organization
Contact information
Practice address
2006 GUS KAPLAN DR STE A, ALEXANDRIA, LA 71301-3377
(318) 484-7310
(318) 484-7374
Mailing address
2006 GUS KAPLAN DR STE A, ALEXANDRIA, LA 71301-3377
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
302F00000X
Exclusive Provider Organization
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2203783331
LOUISIANA DEPARTMENT OF HEALTH
LA
Enumeration date
06/05/2017
Last updated
08/28/2023
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