| Change22, Llc | |
|
733 Thimble Shoals Blvd Suite 170, Office 102 Newport News VA 23606-4260 | |
| (757) 347-0450 | |
| (757) 347-0460 |
| Full Name | Change22, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 733 Thimble Shoals Blvd, Newport News, Virginia |
| Authorized Official Name and Position | Brian Strode (MEMBER) |
| Authorized Official Contact | 7573470450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Change22, Llc 733 Thimble Shoals Blvd Suite 170, Office 102 Newport News VA 23606-4260 Ph: (757) 347-0450 | Change22, Llc 733 Thimble Shoals Blvd Suite 170, Office 102 Newport News VA 23606-4260 Ph: (757) 347-0450 |
| NPI Number | 1952150831 |
|---|---|
| Provider Enumeration Date | 05/14/2024 |
| Last Update Date | 05/14/2024 |
| Certification Date | 05/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952150831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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