Active NPI
Changes Youth and Family Services, Inc.
- Community/Behavioral Health Agency
- Melbourne, FL
National Provider Identifier
1255584033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- CHANGES YOUTH AND FAMILY SERVICES, INC.
- Doing business as
- CHANGES
- Practice address
- 3270 Suntree Blvd
Suite 127
Melbourne, FL 32940-7530 - Phone
- (321) 610-7949
- Fax
- (321) 610-7947
- NPI assigned
- Oct 24, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kwanya Sanders, LMHC
- Title
- Executive Director
- Phone
- (321) 610-7949
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | FL | Primary |
Addresses
Primary practice location
3270 Suntree Blvd
Suite 127
Melbourne, FL 32940-7530
Mailing address
3270 Suntree Blvd
Suite 127
Melbourne, FL 32940-7530
Phone (321) 610-7949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 076875800 | Medicaid | FL |
Other names 1
- CHANGES
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224806400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1224806400000",
"number": "1255584033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3270 SUNTREE BLVD",
"address_2": "SUITE 127",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329407530",
"telephone_number": "321-610-7949",
"fax_number": "321-610-7947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3270 SUNTREE BLVD",
"address_2": "SUITE 127",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329407530",
"telephone_number": "321-610-7949",
"fax_number": "321-610-7947"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHANGES YOUTH AND FAMILY SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-24",
"last_updated": "2008-10-24",
"status": "A",
"authorized_official_last_name": "SANDERS",
"authorized_official_first_name": "KWANYA",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "321-610-7949",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "LMHC"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "076875800",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CHANGES",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.