Organization
CHANGING LEADS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL ALLAN MOORE LICENSED SOCIAL WORK (CEO)
(814) 238-0961
Entity
Organization
Contact information
Practice address
650 BREEZEWOOD DRIVE, STATE COLLEGE, PA 16801
(814) 238-0961
Mailing address
650 BREEZEWOOD DRIVE, STATE COLLEGE, PA 16801
(814) 238-0961
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW126481
PA
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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