Provider Demographics
NPI:1396086658
Name:CHANGING ONE'S PERSPECTIVE
Entity type:Organization
Organization Name:CHANGING ONE'S PERSPECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-402-5075
Mailing Address - Street 1:3969 STERLING POINTE DR
Mailing Address - Street 2:UNIT NNN4
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-5824
Mailing Address - Country:US
Mailing Address - Phone:252-402-5075
Mailing Address - Fax:
Practice Address - Street 1:3969 STERLING POINTE DR
Practice Address - Street 2:UNIT NNN4
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-5824
Practice Address - Country:US
Practice Address - Phone:252-402-5075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health