Provider Demographics
NPI:1689043689
Name:LIFE CHANGES HOME CARE, LLC
Entity Type:Organization
Organization Name:LIFE CHANGES HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NASHAUNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-399-7439
Mailing Address - Street 1:4621 E 43RD TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-2271
Mailing Address - Country:US
Mailing Address - Phone:816-399-7439
Mailing Address - Fax:
Practice Address - Street 1:9504 E 63RD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-4948
Practice Address - Country:US
Practice Address - Phone:816-399-7439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-19
Last Update Date:2015-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health