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NPI 1396086658

NPI 1396086658 : CHANGING ONE'S PERSPECTIVE : WINTERVILLE, NC

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General NPI Number Information
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    NPI Number           |    1396086658
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHANGING ONE'S PERSPECTIVE 
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Dates
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    Enumeration Date     |    03/12/2013
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    Last Update Date     |    03/12/2013
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Provider Practice Location Address
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    Address Line         |    3969 STERLING POINTE DR UNIT NNN4
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    City                 |    WINTERVILLE
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    State                |    NC
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    Zip                  |    28590-5824
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    Country              |    US
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    Telephone            |    252-402-5075
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3969 STERLING POINTE DR UNIT NNN4
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    City                 |    WINTERVILLE
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    State                |    NC
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    Zip                  |    28590-5824
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    Country              |    US
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    Telephone            |    252-402-5075
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     TAMEKA  JENNETTE 
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    Credential           |    
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    Telephone            |    252-402-5075
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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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