Organization
CORNERSTONE OF CHANGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY OLIVER LMFT (MANAGER)
(954) 247-4157
Entity
Organization
Contact information
Practice address
2250 NW 136 AVE, PEMBROKE PINES, FL 33028-2586
(954) 247-4157
Mailing address
5846 S FLAMINGO RD # 513, COOPER CITY, FL 33330-3237
(954) 247-4157
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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