Organization
CHANGING LIVES FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WILLIAMS (ORGANIZER)
(704) 345-0190
Entity
Organization
Contact information
Practice address
120 MAGGIE LN, ROXBORO, NC 27573-2661
(704) 345-2190
Mailing address
120 MAGGIE LN, ROXBORO, NC 27573-2661
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC1900X
Counseling Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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