Changing Phases Behavioral Support One
LBN: Changing Phases Behavioral Support
Changing Phases Behavioral Support One is an health care organization with primary practice located at 1609 Clemmons St , Greensboro NC 27406-2870. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children. Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children is the primary health care specialty.
Changing Phases Behavioral Support can be contacted via phone (336) 333-2542, or through Cullins, Quinten via phone (336) 333-2542.
Contact Information
Primary practice address
1609 Clemmons St
Greensboro NC 27406-2870
Phone: (336) 333-2542
Fax: (336) 333-2858
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Community/Behavioral Health | 251S00000X | ||
| Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children | 322D00000X | MHL-041-794 | North Carolina |
| Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children | 322D00000X | MHL-041-894 | North Carolina |
Profile Details
| NPI number | 1811057045 |
|---|---|
| LBN Legal business name | Changing Phases Behavioral Support |
| DBA Doing business as | Changing Phases Behavioral Support One |
| Authorized official | Cullins, Quinten |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 11th, 2006 |
| Last updated | Mar 12th, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811057045 | NPPES |
| North Carolina | MEDICAID | 6604413 | |
| North Carolina | MEDICAID | 8301765 | |
| North Carolina | MEDICAID | 6006908 | |
| North Carolina | MEDICAID | 8301765G |
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