Healthcare Provider Details

I. General information

NPI: 1952194110
Provider Name (Legal Business Name): CHANGING MINDS TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 CROCKER PARK BLVD STE 4000
WESTLAKE OH
44145-8131
US

IV. Provider business mailing address

159 CROCKER PARK BLVD STE 4000
WESTLAKE OH
44145-8131
US

V. Phone/Fax

Practice location:
  • Phone: 216-804-9447
  • Fax:
Mailing address:
  • Phone: 216-804-9447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANTOINE MATTHEWS
Title or Position: OWNER
Credential:
Phone: 216-804-9447