Provider Demographics
NPI:1033488879
Name:LOGICAL CHOICE LLC
Entity type:Organization
Organization Name:LOGICAL CHOICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KIETRIC
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-643-5542
Mailing Address - Street 1:5575 CONNER ST.
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-6400
Mailing Address - Country:US
Mailing Address - Phone:313-643-5542
Mailing Address - Fax:248-522-7045
Practice Address - Street 1:5575 CONNER ST.
Practice Address - Street 2:SUITE 210
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-6400
Practice Address - Country:US
Practice Address - Phone:313-643-5542
Practice Address - Fax:248-522-7045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency