Organization
CHANGE REACTION, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M GREEN (OWNER/PROGRAM MANAGER)
(301) 408-9639
Entity
Organization
Contact information
Practice address
4404 QUEENSBURY RD STE 105, RIVERDALE, MD 20737-1074
(301) 864-0919
(301) 864-1301
Mailing address
4404 QUEENSBURY RD STE 105, RIVERDALE, MD 20737-1074
(301) 864-0919
(301) 864-1301
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/02/2015
Last updated
12/13/2021
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