Provider Demographics
NPI: | 1699458455 |
---|---|
Name: | CHANGE IN MOTION LLC |
Entity type: | Organization |
Organization Name: | CHANGE IN MOTION LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JADYN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SHARBER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OT |
Authorized Official - Phone: | 406-600-3455 |
Mailing Address - Street 1: | PO BOX 9100 |
Mailing Address - Street 2: | |
Mailing Address - City: | ALLENTOWN |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18105-9100 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 406-600-3455 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 35 N 18TH ST APT 2A |
Practice Address - Street 2: | |
Practice Address - City: | ALLENTOWN |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18104-5668 |
Practice Address - Country: | US |
Practice Address - Phone: | 406-600-3455 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-08-09 |
Last Update Date: | 2023-08-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 225XE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Environmental Modification | Group - Multi-Specialty |
No | 225XE1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Ergonomics | Group - Multi-Specialty |
No | 225XG0600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Gerontology | Group - Multi-Specialty |
No | 225XH1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Hand | Group - Multi-Specialty |
No | 225XH1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Human Factors | Group - Multi-Specialty |
No | 225XL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Low Vision | Group - Multi-Specialty |
No | 225XN1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Neurorehabilitation | Group - Multi-Specialty |
No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | Group - Multi-Specialty |