Provider Demographics
NPI:1801210976
Name:CHANGING TIMES
Entity Type:Organization
Organization Name:CHANGING TIMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:NWANEBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-602-1790
Mailing Address - Street 1:6801 S WESTERN AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-1817
Mailing Address - Country:US
Mailing Address - Phone:405-602-1790
Mailing Address - Fax:405-602-1790
Practice Address - Street 1:6801 S WESTERN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1817
Practice Address - Country:US
Practice Address - Phone:405-602-1790
Practice Address - Fax:405-602-1790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health