Provider Demographics
NPI:1609190768
Name:GENERATIONAL CHANGES, INC.
Entity Type:Organization
Organization Name:GENERATIONAL CHANGES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:VARNELL
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
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:559-681-0533
Mailing Address - Fax:559-486-1199
Practice Address - Street 1:2409 MERCED ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1810
Practice Address - Country:US
Practice Address - Phone:559-681-0533
Practice Address - Fax:559-486-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center