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Organization
THE CHANGE AGENCY
Active
Organization
THE CHANGE AGENCY
Active
Other names
Adullam Sober Living Program
Organization subpart
No
Provider details
NPI number
Authorized official
JEORGE L LOGAN MSSA,LICDC,CPS-S (DIRECTOR)
(937) 303-6727
Entity
Organization
Contact information
Practice address
2400 W STROOP RD, MORAINE, OH 45439-2041
(937) 315-0030
(937) 701-6901
Mailing address
2400 W STROOP RD, MORAINE, OH 45439-2041
(937) 315-0030
(937) 701-6901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
11/20/2020
Last updated
08/28/2025
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