| Life Changez, Inc | |
|
2111 Maywood St Greensboro NC 27403-3107 | |
| (919) 803-2799 | |
| (919) 802-2808 |
| Full Name | Life Changez, Inc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 2111 Maywood St, Greensboro, North Carolina |
| Authorized Official Name and Position | Rene Whitehead (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9195388920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Changez, Inc 1100 Logger Ct Ste A102 Raleigh NC 27609-8506 Ph: (919) 538-8920 | Life Changez, Inc 2111 Maywood St Greensboro NC 27403-3107 Ph: (919) 803-2799 |
| NPI Number | 1184226409 |
|---|---|
| Provider Enumeration Date | 11/11/2020 |
| Last Update Date | 11/11/2020 |
| Certification Date | 11/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184226409 | NPI | - | NPPES |
| 1689829293 | Medicaid | NC | |
| 1730441775 | Medicaid | NC |
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