Healthcare Provider Details

I. General information

NPI: 1699430959
Provider Name (Legal Business Name): GREATER CHANGES TECHNOLOGIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2021
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 CHURCH ST STE 102
CHRISTIANSTED VI
00820-5060
US

IV. Provider business mailing address

441 N CENTRAL AVE STE 1007
OVIEDO FL
32765-7423
US

V. Phone/Fax

Practice location:
  • Phone: 340-277-3079
  • Fax:
Mailing address:
  • Phone: 340-277-3079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TAMARA MOHAMMED
Title or Position: CO FOUNDER
Credential:
Phone: 305-479-6782