MEDICARE: CHANGING PATTERNS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1093534331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANGING PATTERNS INC

Provider Business Mailing Address
First Line	:	2669 NE TWIN KNOLLS DR STE 206
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6206
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2669 NE TWIN KNOLLS DR STE 206
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6206
Country	:	US
Telephone Number	:	541-350-2685
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	FRANK PATKA
Credential	:
Telephone Number	:	541-350-2685

Provider Enumeration Date	:	10/04/2024
Last Update Date	:	10/04/2024

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Directions to “CHANGING PATTERNS INC ” Practice Location

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