Organization Name: | LIFE CHANGEZ INC |
NPI Number: | 1689829293 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RENE LAVONNE COFER (EXECUTIVE DIRECTOR) |
Mailing Address: | 3833 Buffaloe Rd Raleigh |
State: | NC US |
Postal Code: | 276044210 |
Phone Number: | 9192394299 |
Fax Number: | 9198032808 |
NPI Enumeration Date: | 11/24/2008 |
NPI Last Update Date: | 05/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | MHL-092-728 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |