Provider Demographics
NPI:1417730581
Name:DIG-IN-TO CHANGE/KNOWLEDGE, POWER AND WISDOM, LLC
Entity Type:Organization
Organization Name:DIG-IN-TO CHANGE/KNOWLEDGE, POWER AND WISDOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:ANTOINETTE
Authorized Official - Last Name:DIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:CAC-ADS
Authorized Official - Phone:443-602-6531
Mailing Address - Street 1:3201 DUDLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1711
Mailing Address - Country:US
Mailing Address - Phone:667-214-3586
Mailing Address - Fax:
Practice Address - Street 1:1624 ABBOTSTON ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-4949
Practice Address - Country:US
Practice Address - Phone:667-214-3586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health