| Visualize Change, Llc | |
|
913 Centre St Ashland PA 17921-1243 | |
| (570) 875-3333 | |
| (570) 875-3433 |
| Full Name | Visualize Change, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 913 Centre St, Ashland, Pennsylvania |
| Authorized Official Name and Position | Lori Wetzel (FACILITY OWNER) |
| Authorized Official Contact | 5708753333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Visualize Change, Llc 913 Centre St Ashland PA 17921-1243 Ph: (570) 875-3333 | Visualize Change, Llc 913 Centre St Ashland PA 17921-1243 Ph: (570) 875-3333 |
| NPI Number | 1750760492 |
|---|---|
| Provider Enumeration Date | 05/27/2015 |
| Last Update Date | 05/05/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750760492 | NPI | - | NPPES |
| 1030502410001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 547030 (Pennsylvania) | Primary |
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