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NPI Code Detail

MEDICARE: BE THE CHANGE, INC.

MEDICARE: BE THE CHANGE, 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
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1518403385
Entity Type Code : Organization
Provider Name (Legal Business Name) : BE THE CHANGE, INC.
Provider Business Mailing Address
First Line : 1724 NW 4TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-2609
Country : US
Telephone Number : 405-415-8449
Fax Number : 405-415-2359
Provider Business Practice Location Address
First Line : 1724 NW 4TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-2609
Country : US
Telephone Number : 405-415-8449
Fax Number : 405-415-2359
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. JONATHAN ROBERTS
Credential :
Telephone Number : 405-415-8449
Provider Enumeration Date : 01/17/2017
Last Update Date : 01/17/2017

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Directions to “BE THE CHANGE, INC. ” Practice Location

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