Provider Demographics
NPI:1154829869
Name:ADVOCATES FOR CHANGE LLC
Entity Type:Organization
Organization Name:ADVOCATES FOR CHANGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED GUARDIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:KE'PE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-471-5672
Mailing Address - Street 1:2777 BRENTWOOD RD UNIT 40248
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27629-0823
Mailing Address - Country:US
Mailing Address - Phone:910-471-5672
Mailing Address - Fax:919-803-7465
Practice Address - Street 1:3127 MANHASSET LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-3499
Practice Address - Country:US
Practice Address - Phone:910-471-5672
Practice Address - Fax:919-803-7465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-28
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management