| Life Changez, Inc | |
|
800 Perry Howard Rd Fuquay Varina NC 27526-1779 | |
| (919) 577-0021 | |
| (919) 803-2808 |
| Full Name | Life Changez, Inc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 800 Perry Howard Rd, Fuquay Varina, North Carolina |
| Authorized Official Name and Position | Rene Whitehead (OWNER/DIRECTO) |
| Authorized Official Contact | 9198032799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Changez, Inc 1100 Logger Ct Suite A102 Raleigh NC 27609-8525 Ph: (919) 803-2799 | Life Changez, Inc 800 Perry Howard Rd Fuquay Varina NC 27526-1779 Ph: (919) 577-0021 |
| NPI Number | 1912020637 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 07/03/2020 |
| Certification Date | 07/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912020637 | NPI | - | NPPES |
| 6604442 | Medicaid | NC |
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