MEDICARE: TRUE COLORS TANGIBLE CHANGE BEHAVIORAL HEALTH SERVICES LLC

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

General Provider Information

NPI Number	:	1457037715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUE COLORS TANGIBLE CHANGE BEHAVIORAL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	1325 E KEMPER RD STE 211
Second Line	:
City	:	SPRINGDALE
State	:	OH
Zip	:	45246-3921
Country	:	US
Telephone Number	:	513-726-8354
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 E KEMPER RD STE 211
Second Line	:
City	:	SPRINGDALE
State	:	OH
Zip	:	45246-3921
Country	:	US
Telephone Number	:	513-726-8354
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	MRS. KANIYA C MURRAY
Credential	:
Telephone Number	:	513-726-8354

Provider Enumeration Date	:	06/22/2023
Last Update Date	:	06/22/2023

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