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General NPI Number Information
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NPI Number | 1043175599
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Entity Type | Organization
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Legal Business Name | CHANGE IS AN ADVENTURE, LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 4000 N STATE ROAD 7 STE 311
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City | LAUDERDALE LAKES
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State | FL
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Zip | 33319-4871
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Country | US
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Telephone | 786-525-4267
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Fax |
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Provider Business Mailing Address
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Address Line | 6200 NW 44TH ST APT 415
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City | LAUDERHILL
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State | FL
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Zip | 33319-4428
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Country | US
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Telephone | 786-525-4267
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Fax |
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR
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Name | PABLO URIARTE
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Credential | LCSW
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Telephone | 954-394-3095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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