Organization · NPI-2
Affecting Change, LLC
Community/Behavioral Health · Southfield, MI
NPI number1699063297
StatusActive
Last updated in NPPESMar 21, 2022
Details
- NPI
- 1699063297
- Entity type
- Organization (NPI-2)
- Legal business name
- Affecting Change, LLC
- Organization subpart
- No
- Enumeration date
- Jul 16, 2011
- Certification date
- Mar 21, 2022
- Last updated
- Mar 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | D25724 | MI | Yes |
| 1041C0700X | Social Worker, Clinical | – | – |
Practice location
22511 Telegraph Rd Ste 128Southfield, MI 48033-4130
Phone 248-905-1126 · Fax 313-209-8989
Mailing address
22511 Telegraph Rd Ste 128Southfield, MI 48033-4130
Phone 248-905-1126 · Fax 313-209-8989
Authorized official
Andre D Charley
Owner
3135879869
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