Organization
NATIONAL INSTITUTE FOR CHANGE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE MICHELLE KEELING (DIRECTOR OF OPERATIONS)
(303) 231-0090
Entity
Organization
Contact information
Practice address
2600 S PARKER RD STE 5-150, AURORA, CO 80014-1691
(303) 231-0090
(303) 231-0992
Mailing address
3225 S WADSWORTH BLVD UNIT T, LAKEWOOD, CO 80227-5009
(303) 231-0090
(303) 231-0992
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624855
—
CO
Enumeration date
10/22/2020
Last updated
11/12/2020
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