Provider Demographics
NPI:1073840831
Name:CHANGING TIMES TRANSITIONAL SERVICES, INC.
Entity type:Organization
Organization Name:CHANGING TIMES TRANSITIONAL SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-803-7222
Mailing Address - Street 1:5231 HOHMAN AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46320-1741
Mailing Address - Country:US
Mailing Address - Phone:219-803-7222
Mailing Address - Fax:219-803-7541
Practice Address - Street 1:5231 HOHMAN AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-1741
Practice Address - Country:US
Practice Address - Phone:219-803-7222
Practice Address - Fax:219-803-7541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-14
Last Update Date:2009-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2009052600143385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care