NPI | 1891317657 |
---|---|
Doing Business As | CHANGING LIVES THERAPEUTIC SERVICE,LLC |
Entity Type | Organization |
Authorized Contact | CEMETRIUS ROLLE Co Owner 980-833-1121 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X |
Additional Taxonomies | 101YP2500X Counselor, Professional |
1041C0700X Social Worker, Clinical | |
175T00000X Peer Specialist | |
251S00000X Community/Behavioral Health | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
Enumeration Date | 2020-05-14 |
Last Update Date | 2023-06-15 |