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General NPI Number Information
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NPI Number | 1346901659
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Entity Type | Organization
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Legal Business Name | NATIONAL INSTITUTE FOR CHANGE, P.C.
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Dates
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Enumeration Date | 01/07/2022
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 9600 E ARAPAHOE RD STE 220
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80112-3726
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Country | US
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Telephone | 303-231-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 3225 S WADSWORTH BLVD UNIT T
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City | LAKEWOOD
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State | CO
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Zip | 80227-5009
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Country | US
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Telephone | 303-231-0090
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DIANE KEELING
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Credential |
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Telephone | 303-231-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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