Organization
CENTER FOR POSITIVE CHANGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA D HANCOCK LCSW (PRESIDENT)
(574) 360-4066
Entity
Organization
Contact information
Practice address
611 LINCOLN WAY E, SOUTH BEND, IN 46601-3220
(574) 360-4066
Mailing address
611 LINCOLN WAY E, SOUTH BEND, IN 46601-3220
(574) 360-4066
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33007209A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201146720
—
IN
Enumeration date
03/11/2015
Last updated
03/11/2015
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