Provider Demographics
NPI:1174966824
Name:OPENING DOORS TO CHANGE, LLC
Entity type:Organization
Organization Name:OPENING DOORS TO CHANGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAYARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-636-4040
Mailing Address - Street 1:404 KUEHU ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-4500
Mailing Address - Country:US
Mailing Address - Phone:808-636-4040
Mailing Address - Fax:
Practice Address - Street 1:404 KUEHU ST
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4500
Practice Address - Country:US
Practice Address - Phone:808-636-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI32971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty