Healthcare Provider Details

I. General information

NPI: 1730477688
Provider Name (Legal Business Name): THE POWER OF CHANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 N VEL R PHILLIPS AVE STE 131
MILWAUKEE WI
53212-2370
US

IV. Provider business mailing address

2821 N VEL R PHILLIPS AVE STE 131
MILWAUKEE WI
53212-2370
US

V. Phone/Fax

Practice location:
  • Phone: 414-374-8787
  • Fax: 414-374-8181
Mailing address:
  • Phone: 414-374-8787
  • Fax: 414-374-8181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LISA ANNETTE ADAMS-QUALLS
Title or Position: EXECUTIVE DIRECTOR
Credential: SAC, APSW
Phone: 414-431-1688