| Life Changez Inc | |
|
5321 Logos Ct Raleigh NC 27610-3481 | |
| (919) 803-7125 | |
| (919) 803-2808 |
| Full Name | Life Changez Inc |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 5321 Logos Ct, Raleigh, North Carolina |
| Authorized Official Name and Position | Rene Cofer 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) 803-2799 | Life Changez Inc 5321 Logos Ct Raleigh NC 27610-3481 Ph: (919) 803-7125 |
| NPI Number | 1730441775 |
|---|---|
| Provider Enumeration Date | 06/14/2012 |
| Last Update Date | 03/10/2023 |
| Certification Date | 03/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730441775 | NPI | - | NPPES |
| 6604442 | Medicaid | NC |
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