Organization Name: | LASTING CHANGES COUNSELING CENTER, LLC |
NPI Number: | 1053630715 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | M HARPA HUNTRESS (OWNER/SECRETARY) |
Mailing Address: | 1501 State St La Porte |
State: | IN US |
Postal Code: | 463503115 |
Phone Number: | 2193625000 |
Fax Number: | 2193625005 |
NPI Enumeration Date: | 05/20/2010 |
NPI Last Update Date: | 11/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |