Provider Demographics
NPI:1932671849
Name:RIVER OF CHANGE COUNSELING AND LIFE COACHING SERVICES INC.
Entity Type:Organization
Organization Name:RIVER OF CHANGE COUNSELING AND LIFE COACHING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLMERT-GALLITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-475-7830
Mailing Address - Street 1:6767 W GREENFIELD AVE STE LL1
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-4967
Mailing Address - Country:US
Mailing Address - Phone:414-475-7830
Mailing Address - Fax:414-475-7917
Practice Address - Street 1:6767 W GREENFIELD AVE STE LL1
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-4967
Practice Address - Country:US
Practice Address - Phone:414-455-3003
Practice Address - Fax:414-455-3151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty