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General NPI Number Information
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NPI Number | 1164245973
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Entity Type | Organization
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Legal Business Name | MAKING A DIFFERENCE FOUNDATION
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | MAKING A DIFFERENCE FOUNDATION 730 FAWCETT AVE
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City | TACOMA
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State | WA
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Zip | 98402
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Country | US
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Telephone | 253-212-2778
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Fax |
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Provider Business Mailing Address
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Address Line | MAKING A DIFFERENCE FOUNDATION 730 FAWCETT AVE
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City | TACOMA
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State | WA
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Zip | 98402
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Country | US
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Telephone | 253-212-2778
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AHNDREA BLUE
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Credential |
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Telephone | 206-849-2583
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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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