Provider Demographics
NPI:1740428614
Name:EMBRACING CHANGE CENTER, INC.
Entity Type:Organization
Organization Name:EMBRACING CHANGE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:B
Authorized Official - Last Name:WESTERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-442-0012
Mailing Address - Street 1:1621 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-6274
Mailing Address - Country:US
Mailing Address - Phone:252-442-0012
Mailing Address - Fax:242-442-0013
Practice Address - Street 1:1621 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-6274
Practice Address - Country:US
Practice Address - Phone:252-442-0012
Practice Address - Fax:252-442-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-033-060251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health