| Changing Leads Llc | |
|
650 Breezewood Drive State College PA 16801 | |
| (814) 238-0961 | |
| Not Available |
| Full Name | Changing Leads Llc |
|---|---|
| Speciality | Social Worker |
| Location | 650 Breezewood Drive, State College, Pennsylvania |
| Authorized Official Name and Position | Paul Allan Moore (CEO) |
| Authorized Official Contact | 8142380961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing Leads Llc 650 Breezewood Drive State College PA 16801 Ph: (814) 238-0961 | Changing Leads Llc 650 Breezewood Drive State College PA 16801 Ph: (814) 238-0961 |
| NPI Number | 1962650960 |
|---|---|
| Provider Enumeration Date | 09/03/2008 |
| Last Update Date | 09/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962650960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | SW126481 (Pennsylvania) | Primary |
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