Provider Demographics
NPI:1093147720
Name:A CHANGE WITHIN, LLC
Entity Type:Organization
Organization Name:A CHANGE WITHIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CAC III
Authorized Official - Phone:970-685-2647
Mailing Address - Street 1:150 E 29TH ST STE 237
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2765
Mailing Address - Country:US
Mailing Address - Phone:970-685-2647
Mailing Address - Fax:
Practice Address - Street 1:150 E 29TH ST STE 237
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2765
Practice Address - Country:US
Practice Address - Phone:970-685-2647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health