| Change Behavioral Health, Inc. | |
|
501 Sycamore St Ste 623 Waterloo IA 50703-4651 | |
| (319) 233-0323 | |
| (319) 233-5923 |
| Full Name | Change Behavioral Health, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 501 Sycamore St Ste 623, Waterloo, Iowa |
| Authorized Official Name and Position | Shannon Lee Harrington (CHIEF EXECUTOVE OFFICER) |
| Authorized Official Contact | 3192330323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Change Behavioral Health, Inc. 2307 Falls Avenue Suite 4 Waterloo IA 50701-5700 Ph: (319) 233-0323 | Change Behavioral Health, Inc. 501 Sycamore St Ste 623 Waterloo IA 50703-4651 Ph: (319) 233-0323 |
| NPI Number | 1093006017 |
|---|---|
| Provider Enumeration Date | 04/25/2011 |
| Last Update Date | 08/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093006017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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