Organization
CHOICEPOINT MT LLC
Active
Parent organization
CHOICEPOINT LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHOICEPOINT LLC
Authorized official
RYAN KACZKA (MBMR)
(908) 948-8802
Entity
Organization
Contact information
Practice address
1601 2ND AVE N STE 535, GREAT FALLS, MT 59401-3255
(908) 948-8802
Mailing address
6586 ATLANTIC AVE # 4872, DELRAY BEACH, FL 33446-1617
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
09/08/2022
Last updated
10/14/2022
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