| The Life Change Center | |
|
1755 Sullivan Ln Sparks NV 89431-2815 | |
| (775) 499-5534 | |
| (775) 499-5535 |
| Full Name | The Life Change Center |
|---|---|
| Speciality | Psychologist |
| Location | 1755 Sullivan Ln, Sparks, Nevada |
| Authorized Official Name and Position | John Firestone (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7758427436 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Life Change Center 1755 Sullivan Ln Sparks NV 89431-2815 Ph: (775) 499-5534 | The Life Change Center 1755 Sullivan Ln Sparks NV 89431-2815 Ph: (775) 499-5534 |
| NPI Number | 1205389129 |
|---|---|
| Provider Enumeration Date | 07/27/2016 |
| Last Update Date | 06/17/2024 |
| Certification Date | 06/17/2024 |
| Medicare PECOS PAC ID | 4183620602 |
|---|---|
| Medicare Enrollment ID | O20200406002388 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205389129 | NPI | - | NPPES |
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