Provider Demographics
NPI:1316963754
Name:CHOICES CHANGES, INC.
Entity type:Organization
Organization Name:CHOICES CHANGES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZAREWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-268-4441
Mailing Address - Street 1:2298 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-3084
Mailing Address - Country:US
Mailing Address - Phone:407-268-4441
Mailing Address - Fax:407-323-2374
Practice Address - Street 1:2298 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-3084
Practice Address - Country:US
Practice Address - Phone:407-268-4441
Practice Address - Fax:407-323-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH-5437174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty