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General NPI Number Information
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NPI Number | 1326560970
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Entity Type | Organization
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Legal Business Name | CHANGE THROUGH TRANSITION, LTD
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 3375 MERRIAM ST STE 202
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City | MUSKEGON
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State | MI
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Zip | 49444-3173
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Country | US
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Telephone | 586-467-0447
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 150137
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City | GRAND RAPIDS
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State | MI
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Zip | 49515-0137
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Country | US
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Telephone | 616-821-8111
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ELAINE MARIE BEAUCHAMP
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Credential | SOCIAL WORKER
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Telephone | 616-222-0851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 6801057813
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License Number State | MI
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Taxonomy #2
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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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