Provider Demographics
NPI:1457742140
Name:CHOICES BEHAVIORAL HEALTH L.L.C.
Entity type:Organization
Organization Name:CHOICES BEHAVIORAL HEALTH L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH PROFESSIONAL
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREASEN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:507-616-1113
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283-0292
Mailing Address - Country:US
Mailing Address - Phone:507-616-1113
Mailing Address - Fax:507-616-1115
Practice Address - Street 1:221 S MILL ST
Practice Address - Street 2:
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283-1683
Practice Address - Country:US
Practice Address - Phone:507-616-1113
Practice Address - Fax:507-616-1115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN16694251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN80001776Medicare PIN