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General NPI Number Information
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NPI Number | 1801492400
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Entity Type | Organization
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Legal Business Name | CHANGING SKYS FAMILY SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 2 W MAIN ST
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City | GREENFIELD
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State | IN
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Zip | 46140-2387
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Country | US
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Telephone | 317-517-8125
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Fax |
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Provider Business Mailing Address
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Address Line | 1363 WHITE BIRCH LN
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City | GREENFIELD
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State | IN
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Zip | 46140-7142
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Country | US
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Telephone | 317-517-8125
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KANISHA L BRINSON
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Credential |
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Telephone | 317-517-8125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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