Organization
CHANGES1, PLLC
Active
Other names
Changes 1, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NAOMI DIANA TAYLOR LPN (VICE-PRESIDENT)
(313) 695-3951
Entity
Organization
Contact information
Practice address
19940 CONANT, STE A, B, & C, DETROIT, MI 48234-1494
(313) 305-4180
(313) 733-8190
Mailing address
19940 CONANT, STE A, B, & C, DETROIT, MI 48234-1494
(313) 305-4180
(313) 733-8190
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
SA0823228
MI
261QM2800X
Methadone Clinic
—
—
Other
Enumeration date
11/21/2014
Last updated
03/03/2015
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