Provider Demographics
NPI:1205306875
Name:CENTER FOR VALIDATION AND CHANGE, L.L.C.
Entity type:Organization
Organization Name:CENTER FOR VALIDATION AND CHANGE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:AUDREY
Authorized Official - Last Name:LUND
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:612-245-4683
Mailing Address - Street 1:790 CLEVELAND AVE. S. STE., 211
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-3845
Mailing Address - Country:US
Mailing Address - Phone:612-245-4683
Mailing Address - Fax:
Practice Address - Street 1:790 CLEVELAND AVENUE S. STE; 211 790
Practice Address - Street 2:
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116
Practice Address - Country:US
Practice Address - Phone:612-245-4683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty