Provider Demographics
NPI:1023892338
Name:PURPLE CHANGE WELLNESS INSTITUTE OF TRAUMA RECOVERY AND WELL-BEING
Entity type:Organization
Organization Name:PURPLE CHANGE WELLNESS INSTITUTE OF TRAUMA RECOVERY AND WELL-BEING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELAH
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAADC, CCS
Authorized Official - Phone:313-789-7553
Mailing Address - Street 1:7445 ALLEN RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1959
Mailing Address - Country:US
Mailing Address - Phone:313-789-7553
Mailing Address - Fax:
Practice Address - Street 1:7445 ALLEN RD STE 110
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1959
Practice Address - Country:US
Practice Address - Phone:313-789-7553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty