Provider Demographics
NPI:1447709019
Name:DESIGN FOR CHANGE
Entity type:Organization
Organization Name:DESIGN FOR CHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MIKI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-497-8177
Mailing Address - Street 1:1066 E AVENUE J
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-3870
Mailing Address - Country:US
Mailing Address - Phone:661-942-1026
Mailing Address - Fax:
Practice Address - Street 1:44501 16TH ST W
Practice Address - Street 2:SUITE 101
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2884
Practice Address - Country:US
Practice Address - Phone:661-945-5750
Practice Address - Fax:661-945-2317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility