Organization
CHANGE THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SCANNELL (OWNER)
(847) 338-6844
Entity
Organization
Contact information
Practice address
954 EASTPORT CENTRE DR, SUITE B, VALPARAISO, IN 46383-4457
(847) 338-6844
Mailing address
954 EASTPORT CENTRE DR, SUITE B, VALPARAISO, IN 46383-4457
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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