Provider Demographics
NPI:1154927754
Name:A-MAKING CHANGES
Entity type:Organization
Organization Name:A-MAKING CHANGES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JETER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-521-4815
Mailing Address - Street 1:2942 N 24TH ST # 114-766
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7844
Mailing Address - Country:US
Mailing Address - Phone:480-521-4815
Mailing Address - Fax:
Practice Address - Street 1:3146 E WIER AVE STE 35
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-2754
Practice Address - Country:US
Practice Address - Phone:602-305-4782
Practice Address - Fax:602-305-4784
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A-MAKING CHANGES,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community Based
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term CareGroup - Multi-Specialty