| Changin' You | |
|
6415 Omo Rd North Chesterfield VA 23234-5881 | |
| (813) 562-2925 | |
| Not Available |
| Full Name | Changin' You |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6415 Omo Rd, North Chesterfield, Virginia |
| Authorized Official Name and Position | Jamise Brown (CEO) |
| Authorized Official Contact | 8135622925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Changin' You 6415 Omo Rd North Chesterfield VA 23234-5881 Ph: (813) 562-2925 | Changin' You 6415 Omo Rd North Chesterfield VA 23234-5881 Ph: (813) 562-2925 |
| NPI Number | 1124878988 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Medicare PECOS PAC ID | 3476095316 |
|---|---|
| Medicare Enrollment ID | O20240607000369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124878988 | NPI | - | NPPES |
| Provider Name | Jamise Valice Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134892599 PECOS PAC ID: 5294277133 Enrollment ID: I20240607000796 |
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