Provider Demographics
NPI:1336809334
Name:CHALLENGE 2 CHANGE TRANSITION SERVICES, PLLC
Entity Type:Organization
Organization Name:CHALLENGE 2 CHANGE TRANSITION SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, CRC
Authorized Official - Phone:336-403-1192
Mailing Address - Street 1:3980 PREMIER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8409
Mailing Address - Country:US
Mailing Address - Phone:336-370-5311
Mailing Address - Fax:
Practice Address - Street 1:3980 PREMIER DR STE 110
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8409
Practice Address - Country:US
Practice Address - Phone:336-370-5311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-19
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health