| Frontiers In Change Llc | |
|
1719 Grandin Rd Sw Roanoke VA 24015-2815 | |
| (115) 408-1956 | |
| Not Available |
| Full Name | Frontiers In Change Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1719 Grandin Rd Sw, Roanoke, Virginia |
| Authorized Official Name and Position | Benjamin Owen (OWNER) |
| Authorized Official Contact | 5406321434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Frontiers In Change Llc 5052 Pleasant Hill Dr Roanoke VA 24018-3456 Ph: (540) 632-1434 | Frontiers In Change Llc 1719 Grandin Rd Sw Roanoke VA 24015-2815 Ph: (115) 408-1956 |
| NPI Number | 1932830783 |
|---|---|
| Provider Enumeration Date | 06/22/2022 |
| Last Update Date | 06/22/2022 |
| Certification Date | 06/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932830783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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