Provider Demographics
NPI:1518403385
Name:BE THE CHANGE, INC.
Entity Type:Organization
Organization Name:BE THE CHANGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-415-8449
Mailing Address - Street 1:1724 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-2609
Mailing Address - Country:US
Mailing Address - Phone:405-415-8449
Mailing Address - Fax:405-415-2359
Practice Address - Street 1:1724 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-2609
Practice Address - Country:US
Practice Address - Phone:405-415-8449
Practice Address - Fax:405-415-2359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management