Organization
INSPIRING CHANGE TREATMENT AND RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSTANCE B POLITE (OWNER/CEO)
(336) 816-0343
Entity
Organization
Contact information
Practice address
1785 E SAHARA AVE STE 255, LAS VEGAS, NV 89104-3716
(336) 816-0343
Mailing address
42080 W SOMERSET DR, MARICOPA, AZ 85138-3277
(336) 816-0343
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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