Provider Demographics
NPI:1013170851
Name:HOUSE OF CHANGE
Entity Type:Organization
Organization Name:HOUSE OF CHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:281-944-9134
Mailing Address - Street 1:1795 N FRY RD # 495
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-3347
Mailing Address - Country:US
Mailing Address - Phone:281-944-9134
Mailing Address - Fax:
Practice Address - Street 1:20334 DESERT WILLOW DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-5665
Practice Address - Country:US
Practice Address - Phone:281-944-9134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty