Provider Demographics
NPI:1962210963
Name:CHOICE CARE HEALTH GROUP
Entity type:Organization
Organization Name:CHOICE CARE HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EJEMEARE
Authorized Official - Middle Name:
Authorized Official - Last Name:IGENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-831-4710
Mailing Address - Street 1:6111 FLUTIE LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1483
Mailing Address - Country:US
Mailing Address - Phone:443-831-4710
Mailing Address - Fax:410-744-0093
Practice Address - Street 1:6111 FLUTIE LN
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1483
Practice Address - Country:US
Practice Address - Phone:443-831-4710
Practice Address - Fax:410-744-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-21
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities