Provider Demographics
NPI:1205037900
Name:LIFE CHOICES UNLIMITED, INC.
Entity type:Organization
Organization Name:LIFE CHOICES UNLIMITED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-316-4506
Mailing Address - Street 1:PO BOX 2344
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-2344
Mailing Address - Country:US
Mailing Address - Phone:956-316-4506
Mailing Address - Fax:956-316-0064
Practice Address - Street 1:2338 E FREDDY GONZALEZ DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-3883
Practice Address - Country:US
Practice Address - Phone:956-316-4506
Practice Address - Fax:956-316-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXHCS MEDICAID WAIVER251B00000X, 251C00000X, 320900000X, 385HR2060X
TXTXHML MEDICAID WAIVE251C00000X, 385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child