Provider Demographics
NPI:1114608122
Name:LIFE CHANGING CARE
Entity Type:Organization
Organization Name:LIFE CHANGING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CEO
Authorized Official - Prefix:
Authorized Official - First Name:YOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-236-3846
Mailing Address - Street 1:5554 WORCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-3726
Mailing Address - Country:US
Mailing Address - Phone:720-236-3846
Mailing Address - Fax:
Practice Address - Street 1:5554 WORCHESTER ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-3726
Practice Address - Country:US
Practice Address - Phone:720-236-3846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health