| The Change Agency | |
|
2400 W Stroop Rd Moraine OH 45439-2041 | |
| (937) 315-0030 | |
| (937) 701-6901 |
| Full Name | The Change Agency |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2400 W Stroop Rd, Moraine, Ohio |
| Authorized Official Name and Position | Jeorge L Logan (DIRECTOR) |
| Authorized Official Contact | 9373036727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Change Agency 2400 W Stroop Rd Moraine OH 45439-2041 Ph: (937) 315-0030 | The Change Agency 2400 W Stroop Rd Moraine OH 45439-2041 Ph: (937) 315-0030 |
| NPI Number | 1306449384 |
|---|---|
| Provider Enumeration Date | 11/20/2020 |
| Last Update Date | 11/20/2020 |
| Certification Date | 11/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306449384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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