Organization Active NPI

Changes

  • Community/Behavioral Health Agency
  • Melbourne, FL
National Provider Identifier
1790976058
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHANGES
Practice address
3270 Suntree Blvd
Suite 127
Melbourne, FL 32940-7530
Phone
(321) 255-7991
Fax
(321) 639-3207
NPI assigned
Aug 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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) 255-7991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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) 255-7991

National Provider Directory

National Provider Directory
Tax ID family
Changes2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1790976058",
    "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": "321-255-7991",
            "fax_number": "321-639-3207"
        },
        {
            "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": "321-255-7991",
            "fax_number": "321-639-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "KWANYA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-255-7991",
        "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": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 1, 2007; 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.