Organization
CHANGE AGENTS OF SOCIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADEN HINES (CHIEF EXECUTIVE OFFICER)
(702) 305-0652
Entity
Organization
Contact information
Practice address
840 CANTON GRASS LN, LA MARQUE, TX 77568-1007
(702) 305-0652
Mailing address
840 CANTON GRASS LN, LA MARQUE, TX 77568-1007
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up