Provider Demographics
NPI:1386400315
Name:CHOICES COUNSELING AND SKILLS TRAINING CENTER LLC
Entity type:Organization
Organization Name:CHOICES COUNSELING AND SKILLS TRAINING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMAAL
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-968-0719
Mailing Address - Street 1:5201 SW WESTGATE DR STE 222
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-2425
Mailing Address - Country:US
Mailing Address - Phone:757-968-0719
Mailing Address - Fax:
Practice Address - Street 1:5201 SW WESTGATE DR STE 222
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221-2425
Practice Address - Country:US
Practice Address - Phone:757-968-0719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)