| Time for Change | |
|
1651 Tulip Ave District Heights MD 20747-2622 | |
| (202) 403-9206 | |
| Not Available |
| Full Name | Time for Change |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1651 Tulip Ave, District Heights, Maryland |
| Authorized Official Name and Position | Tonya Ridley (CEO) |
| Authorized Official Contact | 2027688454 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Time for Change 1929 Valley Ter Se Washington DC 20032-4627 Ph: (202) 768-8454 | Time for Change 1651 Tulip Ave District Heights MD 20747-2622 Ph: (202) 403-9206 |
| NPI Number | 1518319573 |
|---|---|
| Provider Enumeration Date | 07/01/2016 |
| Last Update Date | 07/01/2016 |
| Medicare PECOS PAC ID | 2769720887 |
|---|---|
| Medicare Enrollment ID | O20190215001397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518319573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PRC14577 (District Of Columbia) | Primary |
| Provider Name | Tonya Ridley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164875266 PECOS PAC ID: 3476891599 Enrollment ID: I20250623004098 |
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