Provider Demographics
NPI:1902186760
Name:MAKING CHANGES, INC.
Entity Type:Organization
Organization Name:MAKING CHANGES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRACE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCAS
Authorized Official - Phone:252-258-5303
Mailing Address - Street 1:3475 AIRPORT BLVD NW
Mailing Address - Street 2:STE. G
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-8687
Mailing Address - Country:US
Mailing Address - Phone:252-258-5303
Mailing Address - Fax:
Practice Address - Street 1:3475 AIRPORT BLVD NW
Practice Address - Street 2:STE. G
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-8687
Practice Address - Country:US
Practice Address - Phone:252-258-5303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3410149Medicaid