Provider Demographics
NPI:1063604593
Name:ITS ALL ABOUT CHOICES
Entity type:Organization
Organization Name:ITS ALL ABOUT CHOICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:TOMKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:208-221-2357
Mailing Address - Street 1:348 S 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-6414
Mailing Address - Country:US
Mailing Address - Phone:208-221-2357
Mailing Address - Fax:208-235-1503
Practice Address - Street 1:348 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-6414
Practice Address - Country:US
Practice Address - Phone:208-221-2357
Practice Address - Fax:208-235-1503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAPPLIED FOR251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health