Organization
MAKE A CHANGE TRANSITIONAL CENTER FOR WOMEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAMIE KELLEY (FOUNDER)
(616) 334-3602
Entity
Organization
Contact information
Practice address
11710 BRIAR FOREST DR APT 1806, HOUSTON, TX 77077-5043
(616) 334-3602
Mailing address
11710 BRIAR FOREST DR APT 1806, HOUSTON, TX 77077-5043
(616) 334-3602
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
06/08/2022
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