Provider Demographics
NPI:1205372257
Name:LIFE CHANGES HUMAN SERVICES INC.
Entity Type:Organization
Organization Name:LIFE CHANGES HUMAN SERVICES INC.
Other - Org Name:SAUNDERS CONSULTING OUTREACH SERVICES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-215-8151
Mailing Address - Street 1:5836 BROGDON RD
Mailing Address - Street 2:
Mailing Address - City:ALCOLU
Mailing Address - State:SC
Mailing Address - Zip Code:29001-9534
Mailing Address - Country:US
Mailing Address - Phone:980-474-8660
Mailing Address - Fax:704-946-2100
Practice Address - Street 1:5227 EAGLE CREEK DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1575
Practice Address - Country:US
Practice Address - Phone:980-474-8660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health