Organization
CHANGE PSYCHOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHAD LOUIS WIEBER (OWNER)
(616) 366-3780
Entity
Organization
Contact information
Practice address
5304 ALPINE AVE NW, COMSTOCK PARK, MI 49321-9708
(616) 366-3780
Mailing address
4134 CAMBOT CT NW, GRAND RAPIDS, MI 49534-1100
(616) 366-3780
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6301015319
MI
Other
Enumeration date
01/04/2017
Last updated
01/05/2017
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