| Change And Evolve | |
|
14634 Diane Manor Ln Humble TX 77396-4560 | |
| (702) 466-4841 | |
| Not Available |
| Full Name | Change And Evolve |
|---|---|
| Speciality | Case Management |
| Location | 14634 Diane Manor Ln, Humble, Texas |
| Authorized Official Name and Position | Cassandra Black (CEO) |
| Authorized Official Contact | 7024664841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Change And Evolve Po Box 273 Humble TX 77347-0273 Ph: (702) 466-4841 | Change And Evolve 14634 Diane Manor Ln Humble TX 77396-4560 Ph: (702) 466-4841 |
| NPI Number | 1083317366 |
|---|---|
| Provider Enumeration Date | 03/24/2023 |
| Last Update Date | 05/18/2023 |
| Certification Date | 05/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083317366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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