Organization
CENTER FOR CHANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ULYSESS GRAY (PRESIDENT)
(757) 544-5020
Entity
Organization
Contact information
Practice address
6325 N CENTER DR STE 202, NORFOLK, VA 23502-0019
(757) 544-5020
(757) 227-3642
Mailing address
909 AUDUBON CIR, CHESAPEAKE, VA 23320-0663
(757) 544-5020
(757) 227-3642
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/20/2015
Last updated
05/20/2015
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