CHOICE COMMUNITY LIVING SERVICES (NPI# 1104127885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104127885 |
| Entity Type | Organization |
| Organization Name | CHOICE COMMUNITY LIVING SERVICES |
| Practice Address |
1037 Whetstone Ct Raleigh NC 27615-5827 |
| Mailing Address |
7719 Falcon Rest Cir Raleigh NC 27615-2561 |
| Practice Telephone | 9198014247 |
| Mailing Telephone | 9198014247 |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2011-02-14 |
| Authorized Official Name | MRS. SHANDRA JONES ROSS (OWNER/OPERATIONS MANAGER) |
| Authorized Official Telephone | 9198014247 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
1037 WHETSTONE CT |
| City | RALEIGH |
| State | NC |
| Zip Code | 27615-5827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278535 | Emily Grace Johnson | Behavior Technician | 119 Wind Chime Court, Suite 4, Raleigh, NC 27615 | 2020-09-06 |
| 1730706110 | Maja V Martin, Dds, Pa1 | Clinic/Center | 7371 Six Forks Road, Raleigh, NC 27615 | 2020-07-01 |
| 1972146967 | Atlantic Avenue Pharmaceutical, Inc | Pharmacy | 5621 Atlantic Ave, Suite 103, Raleigh, NC 27615 | 2019-10-22 |
| 1023503950 | Siyara Shannay Dobbs | Social Worker | 7013 Woodbend Dr Apt H, Raleigh, NC 27615 | 2018-06-23 |
| 1194210153 | Brittanie Ja'nell Harris | Dentist | 1911 Falls Valley Dr Ste 107, Raleigh, NC 27615 | 2018-06-22 |
| 1710489448 | Sherise Swensen | Social Worker | 8368 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2018-03-08 |
| 1881100345 | Casey Paul Baine | Counselor | 6330 Falls of Neuse Rd Ste 104, Raleigh, NC 27615 | 2017-12-20 |
| 1588177885 | Michael Lacidonia | Acupuncturist | 6400 Falls of Neuse Rd Ste 200, Raleigh, NC 27615 | 2017-11-08 |
| 1457877631 | Matt Henderson | Behavioral Analyst | 8374 Six Forks Road, Suite 101, Raleigh, NC 27615 | 2017-08-18 |
| 1760907646 | Shakeda Muldrow | Social Worker | 7323 Brookbank Lane, Raleigh, NC 27615 | 2017-08-11 |
| Find all providers in zip 27615 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114490877 | Brenda Gail Cannon | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3105 Vico Ter, Raleigh, NC 27610-5951 | 2019-01-05 |
| 1144648452 | Tlc Operations, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 743 Chappell Drive, Raleigh, NC 27606-3215 | 2014-04-03 |
| 1649694423 | Miley Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1813 Elkpark Drive, Raleigh, NC 27610 | 2014-02-13 |
| 1659708790 | Dowtin's Therapeutic Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3912 Willow Oak Rd, Raleigh, NC 27604-4725 | 2013-10-03 |
| 1821420829 | Mailey Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1813 Elkpark Dr, Raleigh, NC 27610-5897 | 2013-08-01 |
| 1982043576 | Kersey Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1208 Armstrong Circle, Raleigh, NC 27610 | 2013-06-18 |
| 1801235551 | Mcclain Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 712 Cupola Dr, Raleigh, NC 27603-3440 | 2013-06-17 |
| 1700225539 | Sykes Home 1 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2532 Birchford Court, Raleigh, NC 27604 | 2013-06-14 |
| 1285073023 | Terry's Safe Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8112 Running Cedar Trail, Raleigh, NC 27615 | 2013-06-14 |
| 1720427529 | Hamilton Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4280 Saubranch Hill Street, Raleigh, NC 27616 | 2013-06-14 |
| Find all providers in RALEIGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.