MEDICARE: CHANGES MH 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1699581520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANGES MH LLC

Provider Business Mailing Address
First Line	:	2787 BRISTOL ST
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92626-5956
Country	:	US
Telephone Number	:	949-227-0412
Fax Number	:

Provider Business Practice Location Address
First Line	:	2787 BRISTOL ST
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92626-5956
Country	:	US
Telephone Number	:	949-227-0412
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DAVID DAVUTOGLU
Credential	:
Telephone Number	:	949-873-2106

Provider Enumeration Date	:	12/05/2024
Last Update Date	:	02/10/2026

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Directions to “CHANGES MH LLC ” Practice Location

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