Provider Demographics
NPI:1174818470
Name:GENERATIONAL CHANGES, INC
Entity Type:Organization
Organization Name:GENERATIONAL CHANGES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:V
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-681-0533
Mailing Address - Street 1:1313 P ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1827
Mailing Address - Country:US
Mailing Address - Phone:559-704-9011
Mailing Address - Fax:559-230-3093
Practice Address - Street 1:3333 N BOND AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-5712
Practice Address - Country:US
Practice Address - Phone:559-681-0533
Practice Address - Fax:559-230-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health