The Center For Change Pllc | |
3230 Creek Shadows Dr Kingwood TX 77339-1225 | |
(832) 480-1871 | |
Not Available |
Full Name | The Center For Change Pllc |
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Speciality | Case Management |
Location | 3230 Creek Shadows Dr, Kingwood, Texas |
Authorized Official Name and Position | Jill Wheeler (CLINICAL DIRECTOR) |
Authorized Official Contact | 8324261397 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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The Center For Change Pllc 3230 Creek Shadows Dr Kingwood TX 77339-1225 Ph: (832) 480-1871 | The Center For Change Pllc 3230 Creek Shadows Dr Kingwood TX 77339-1225 Ph: (832) 480-1871 |
NPI Number | 1497498489 |
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Provider Enumeration Date | 04/18/2022 |
Last Update Date | 04/28/2022 |
Certification Date | 04/28/2022 |
Medicare PECOS PAC ID | 1355723123 |
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Medicare Enrollment ID | O20220727001412 |
Identifier | Type | State | Issuer |
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1497498489 | NPI | - | NPPES |
Provider Name | Reneka Dujuan Clark |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1962875583 PECOS PAC ID: 4789965658 Enrollment ID: I20220609000505 |
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