Organization
BRAVE CHANGES, LLC
Active
Other names
Brave Changes, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LORI-ANA GUILLEN (LCSW)
(414) 666-4211
Entity
Organization
Contact information
Practice address
7250 S BALLPARK DR APT 106, FRANKLIN, WI 53132-7026
(414) 666-4211
Mailing address
7250 S BALLPARK DR APT 106, FRANKLIN, WI 53132-7026
(414) 666-4211
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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