Provider Demographics
NPI:1356736342
Name:LIFE CHANGING SOLUTIONS
Entity type:Organization
Organization Name:LIFE CHANGING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CERVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-808-4285
Mailing Address - Street 1:1700 ALTA DR
Mailing Address - Street 2:1095
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4880 E BONANZA RD
Practice Address - Street 2:SUITE 9
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-3469
Practice Address - Country:US
Practice Address - Phone:702-489-8172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00527-P251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health