Organization
CHANGE AND EVOLVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA BLACK (CEO)
(702) 466-4841
Entity
Organization
Contact information
Practice address
14634 DIANE MANOR LN, HUMBLE, TX 77396-4560
(702) 466-4841
Mailing address
PO BOX 273, HUMBLE, TX 77347-0273
(702) 466-4841
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/24/2023
Last updated
05/18/2023
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