Change Agents of Social Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CHANGE AGENTS OF SOCIAL SERVICES

Practice address

840 Canton Grass LN
La Marque, TX 77568-1007

Phone

(702) 305-0652

NPI assigned

Feb 26, 2024

Last updated

Feb 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jaden Hines

Title

Chief Executive Officer

Phone

(702) 305-0652

Specialties & licenses 8

Addresses

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1902662984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 CANTON GRASS LN",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775681007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 CANTON GRASS LN",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775681007",
            "telephone_number": "702-305-0652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE AGENTS OF SOCIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "JADEN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "702-305-0652"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Van Thuy Tuong Cao
• Joseph M Cavazos, DDS
• Cedar Medical Clinic
• Cedarlake Dental Associates, Inc.
• Center for Primary Care Specialists, P.a.
• City of Lamarque (LaMarque Fire Rescue)
• Dallas Kennedy Collins
• David Colmenar
• CVS Pharmacy Inc (CVS Pharmacy #10598)
• David D Nguyen OD PLLC

• Community/Behavioral Health Agency in La Marque, TX
• Providers in La Marque, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.