Organization
GREATER CHANGES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARIK MALACHI MCMILLAN M.S.ED (OWNER)
(340) 332-2717
Entity
Organization
Contact information
Practice address
40 EG LAGRANGE, FREDERIKSTED, VI 00841-0084
(340) 332-2717
Mailing address
PO BOX 411, CHRISTIANSTED, VI 00821-0411
(340) 332-2717
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2-43354-1L
VIRGIN ISLANDS DEPARTMENT OF LICENSING AND CONSUMER AFFAIRS
VI
Enumeration date
02/06/2019
Last updated
02/06/2019
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