Provider Demographics
NPI:1447552492
Name:CHANGE IS POSSIBLE
Entity type:Organization
Organization Name:CHANGE IS POSSIBLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ZITNY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:586-202-3695
Mailing Address - Street 1:2122 15 MILE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4853
Mailing Address - Country:US
Mailing Address - Phone:586-264-3692
Mailing Address - Fax:586-939-5953
Practice Address - Street 1:2122 15 MILE RD
Practice Address - Street 2:SUITE B
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4853
Practice Address - Country:US
Practice Address - Phone:586-264-3692
Practice Address - Fax:586-939-5953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008406251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management