Provider Demographics
NPI:1184215337
Name:CHANGING SEASONS LLC
Entity Type:Organization
Organization Name:CHANGING SEASONS LLC
Other - Org Name:RAISING WELL, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HERSHONIK
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:203-430-0077
Mailing Address - Street 1:19044 SE ARNOLD DR.
Mailing Address - Street 2:
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19044 SE ARNOLD DR.
Practice Address - Street 2:
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469
Practice Address - Country:US
Practice Address - Phone:203-430-0077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-31
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health