Provider Demographics
NPI:1003477662
Name:EMBRACING CHANGES CENTER FOR WELLNESS LLC
Entity Type:Organization
Organization Name:EMBRACING CHANGES CENTER FOR WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-493-7705
Mailing Address - Street 1:32450 TALIMENA LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5839
Mailing Address - Country:US
Mailing Address - Phone:813-486-4920
Mailing Address - Fax:813-428-5756
Practice Address - Street 1:4830 W KENNEDY BLVD STE 630
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2571
Practice Address - Country:US
Practice Address - Phone:813-486-4920
Practice Address - Fax:813-428-5756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW11254OtherDOH