Provider Demographics
NPI:1457127714
Name:BE THE CHANGE RESIDENTIAL SERVICES
Entity Type:Organization
Organization Name:BE THE CHANGE RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:WRAY
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-265-1718
Mailing Address - Street 1:3514 EDGEFIELD AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2654
Mailing Address - Country:US
Mailing Address - Phone:330-265-1718
Mailing Address - Fax:
Practice Address - Street 1:3514 EDGEFIELD AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-2654
Practice Address - Country:US
Practice Address - Phone:330-265-1718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health