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Organization
STANDING FOR CHANGE LLC
Active
Organization
STANDING FOR CHANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSMAN BANGURA (MANAGER)
(323) 424-2269
Entity
Organization
Contact information
Practice address
22601 N 30TH AVE, PHOENIX, AZ 85027-1005
(623) 853-7316
Mailing address
22601 N 30TH AVE, PHOENIX, AZ 85027-1005
(623) 853-7316
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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