Provider Demographics
NPI:1811254972
Name:CHANGING PLACES
Entity type:Organization
Organization Name:CHANGING PLACES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:919-479-9050
Mailing Address - Street 1:3925 N DUKE ST
Mailing Address - Street 2:SUITE 102-A
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-1780
Mailing Address - Country:US
Mailing Address - Phone:919-479-9050
Mailing Address - Fax:919-479-9055
Practice Address - Street 1:725 HANSON RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1117
Practice Address - Country:US
Practice Address - Phone:919-479-9050
Practice Address - Fax:919-479-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-032-119320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities