Provider Demographics
NPI:1609645407
Name:CHANGING LIVES INCORPORATION
Entity Type:Organization
Organization Name:CHANGING LIVES INCORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:LEGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-697-0727
Mailing Address - Street 1:2815 SURF DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-3306
Mailing Address - Country:US
Mailing Address - Phone:270-697-0727
Mailing Address - Fax:
Practice Address - Street 1:2815 SURF DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-3306
Practice Address - Country:US
Practice Address - Phone:270-697-0727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care