NPIMap

Organization Active NPI

Choices for Life of Georgia, LLC

  • Community/Behavioral Health Agency
  • Valdosta, GA
National Provider Identifier
1841328960
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
CPFC001072 Issued in GA
Legal business name
CHOICES FOR LIFE OF GEORGIA, LLC
Practice address
2200 N Patterson Street
Suite D
Valdosta, GA 31602-2573
Phone
(229) 244-1707
Fax
(229) 244-1779
NPI assigned
Mar 1, 2007
Last updated
Apr 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sara Riley, EXECUTIVE DIRECTORNPI 1225163884
Title
Executive Director
Phone
(229) 244-1707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CPFC001072 GA Primary

Addresses

Primary practice location

2200 N Patterson Street
Suite D
Valdosta, GA 31602-2573

Mailing address

2200 N Patterson Street
Suite D
Valdosta, GA 31602-2573
Phone (229) 244-1707

Other identifiers 2

IdentifierTypeStateIssuer
001462443AMedicaidGA
631155790AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Choices for Life of Georgia LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2200 N Patterson St
Ste D
Valdosta, GA 31602
Phone (229) 244-1707

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1841328960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N PATTERSON STREET",
            "address_2": "SUITE D",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022573",
            "telephone_number": "229-244-1707",
            "fax_number": "229-244-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N PATTERSON STREET",
            "address_2": "SUITE D",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022573",
            "telephone_number": "229-244-1707",
            "fax_number": "229-244-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICES FOR LIFE OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "229-244-1707",
        "authorized_official_credential": "EXECUTIVE DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "CPFC001072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001462443A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "631155790A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.