Active Change Center

LBN: Active Change Center, Llc
Active Change Center is an health care organization with primary practice located at 2498 N Stokesberry Pl. Suite 180, Meridian ID 83646. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is the primary health care specialty. Active Change Center, Llc can be contacted via phone (208) 403-7488, or through Rasco, Danny Lee via phone (208) 201-9513.

Contact Information

Primary practice address
2498 N Stokesberry Pl. Suite 180 Meridian ID 83646
Phone: (208) 403-7488
Fax: (208) 529-1960
Website:
Map and Directions
Authorized official contact:
Name: Rasco, Danny Lee
Phone: (208) 201-9513

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X LCPC206 Idaho
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1497028161
LBN Legal business name Active Change Center, Llc
DBA Doing business as Active Change Center
Authorized official Rasco, Danny Lee
Entity Organization
Organization subpart 1 No
Enumeration date Feb 10th, 2012
Last updated Jul 12th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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