Healthcare Provider Details

I. General information

NPI: 1184801326
Provider Name (Legal Business Name): STRATEGIES FOR CHANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 06/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NEW MARKET DR
SACRAMENTO CA
95835-2238
US

IV. Provider business mailing address

4441 AUBURN BLVD SUITE E
SACRAMENTO CA
95841-4139
US

V. Phone/Fax

Practice location:
  • Phone: 916-473-5764
  • Fax:
Mailing address:
  • Phone: 916-473-5764
  • Fax: 916-473-5766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number340084AN
License Number StateCA

VIII. Authorized Official

Name: MS. CYNTHIA KEETH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 916-473-5764