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General NPI Number Information
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NPI Number | 1861002768
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Entity Type | Organization
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Legal Business Name | CHAMBERS FOR LIFE CHANGE
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 118 W SOUTH BOUNDARY ST
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City | PERRYSBURG
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State | OH
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Zip | 43551-5102
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Country | US
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Telephone | 567-218-1207
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Fax |
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Provider Business Mailing Address
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Address Line | 3244 CHASENWOOD WAY
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City | PERRYSBURG
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State | OH
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Zip | 43551-6942
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Country | US
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Telephone | 567-277-2715
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | KRISTEN DIANE BLESSING
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Credential |
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Telephone | 567-218-1207
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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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