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General NPI Number Information
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NPI Number | 1720619356
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Entity Type | Organization
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Legal Business Name | CHANGE AGENT NETWORK AFRICA,INC.
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Dates
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Enumeration Date | 02/02/2020
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Last Update Date | 02/02/2020
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Provider Practice Location Address
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Address Line | 4801 SIPPLE AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-5605
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Country | US
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Telephone | 240-524-0636
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Fax |
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Provider Business Mailing Address
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Address Line | 4801 SIPPLE AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-5605
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Country | US
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Telephone | 240-524-0636
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | EMILE D. ASHWOOD
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Credential | MED/EDUCATIONA
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Telephone | 240-524-0636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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