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General NPI Number Information
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NPI Number | 1083198113
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Entity Type | Organization
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Legal Business Name | CHANGES RECOVERY COUNSELING
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 04/10/2019
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Provider Practice Location Address
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Address Line | 2220 NEVADA WEST BLVD STE 2
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City | PAHRUMP
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State | NV
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Zip | 89048-5870
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Country | US
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Telephone | 775-525-7300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 117
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City | PAHRUMP
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State | NV
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Zip | 89041-0117
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Country | US
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Telephone | 775-525-7300
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JACLYN SUTTON RANGEL
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Credential | CADC
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Telephone | 775-525-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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