Provider Demographics
NPI:1720641509
Name:PROCESS OF CHANGES
Entity Type:Organization
Organization Name:PROCESS OF CHANGES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:OHIKU
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITTIONER
Authorized Official - Phone:410-404-7651
Mailing Address - Street 1:1000 INGLESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1317
Mailing Address - Country:US
Mailing Address - Phone:443-551-3784
Mailing Address - Fax:443-551-3801
Practice Address - Street 1:1000 INGLESIDE AVE STE 1
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1317
Practice Address - Country:US
Practice Address - Phone:443-551-3784
Practice Address - Fax:443-551-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health