Change Agents of Social Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CHANGE AGENTS OF SOCIAL SERVICES LLC

Practice address

2709 Positive CT
North Las Vegas, NV 89031-0947

Phone

(702) 305-0652

NPI assigned

Jul 13, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christopher Hannible

Title

Chief Executive Officer

Phone

(702) 305-0652

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689206400000",
    "number": "1780363044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 POSITIVE CT",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890310947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 POSITIVE CT",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890310947",
            "telephone_number": "702-305-0652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE AGENTS OF SOCIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A",
        "authorized_official_last_name": "HANNIBLE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "702-305-0652"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faith Chaney
• Shaunicia Latrice Chaney
• Alice Chun Feng Chang, DDS
• Billy Chang
• Dennis Ta-Jen Chang, MD
• Elizabeth B Chapa, CSW INTERN
• Sandra Fay Chapin
• Geraldine Christina Chapman-Spencer, LMSW, LCSW
• Laschelle D Chapman
• Richard Daryl Enriquez Chapman

• Community/Behavioral Health Agency in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.