1952420614 NPI number — CHOICES FOR PEOPLE CENTER FOR CITIZENS WITH DISABILITIES INC

Table of content: (NPI 1952420614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952420614 NPI number — CHOICES FOR PEOPLE CENTER FOR CITIZENS WITH DISABILITIES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHOICES FOR PEOPLE CENTER FOR CITIZENS WITH DISABILITIES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952420614
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1840 E STATE HWY 72
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROLLA
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65401-3995
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-364-7444
Provider Business Mailing Address Fax Number:
573-364-5370

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
394 OLD ROUTE 66
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT ROBERT
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65584-3829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-336-3509
Provider Business Practice Location Address Fax Number:
573-649-7056
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
EVANS
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
573-364-7444

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0600X , with the licence number: 658 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 295046502 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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