LIFE CHANGES, INC. (NPI# 1720611304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720611304 |
| Entity Type | Organization |
| Organization Name | LIFE CHANGES, INC. |
| Practice Address |
1195 Kings Row Reno NV 89503-3524 |
| Mailing Address |
Po Box 3137 Sparks NV 89432-3137 |
| Practice Telephone | 7756858145 |
| Mailing Telephone | 7752008827 |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2020-02-21 |
| Authorized Official Name | NATHAN JERSEY (PROGRAM EVALUATOR) |
| Authorized Official Telephone | 7752008827 |
| Authorized Official Credential | MSCJ, PS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1508 1st St, Sparks, NV 894313230 | 7756858145 | |
| 541 W 2nd St, Reno, NV 895035310 | 7756858145 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | LIFE CHANGES, INC. | 2001 West Main St, Stamford, CT 06982 |
| Street Address |
1195 KINGS ROW |
| City | RENO |
| State | NV |
| Zip Code | 89503-3524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639654932 | Board of Regents, Nevada System of Higher Education | Assistant Behavior Analyst | 401 West 2nd Street, Reno, NV 89503 | 2018-10-02 |
| 1356825392 | Shelby Downs | Behavior Technician | 2730 W 7th St, Reno, NV 89503 | 2018-09-15 |
| 1659805570 | Lee Ann Malone | Counselor | 200 W 1st St, Ste 200, Reno, NV 89503 | 2017-04-18 |
| 1255786828 | Eric Allen Hare | Counselor | 1201 North Stewart Street, Sutie 120, Carson City, NV 89503 | 2016-05-02 |
| 1407226095 | Travis B Adams | Dentist | 855 W Seventh St, Ste 200, Reno, NV 89503 | 2015-09-25 |
| 1477933877 | Shawn Mahan | Counselor | 900 W. First Streeet, Reno, NV 89503 | 2015-06-02 |
| 1801144431 | Yesenia Hernandez | Community Health Worker | 900w 1st Street Ste.200, Reno, NV 89503 | 2012-08-29 |
| 1053667501 | Barbara Frey | Social Worker | 580 W 5th Street, Reno, NV 89503 | 2012-08-01 |
| 1548546146 | The Note-ables | Day Training, Developmentally Disabled Services | 925 Riverside Drive, Suite 6, Reno, NV 89503 | 2011-10-26 |
| 1194011270 | Joanne Krumpe | Psychologist | 507 W. 6th St, Reno, NV 89503 | 2011-06-27 |
| Find all providers in zip 89503 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316593940 | Ronald Parker | Prevention Professional | 499 Sierra Vista Dr Apt 6, Las Vegas, NV 89169-2754 | 2019-08-09 |
| 1902451792 | Jacqueline Hendricks | Prevention Professional | 4525 Dean Martin Dr Unit 501, Las Vegas, NV 89103-8107 | 2019-08-07 |
| 1588105530 | Jessica Dawn Harty | Prevention Professional | 6299 Tillman Crest Ave, Las Vegas, NV 89139-6868 | 2017-03-10 |
| 1780120642 | Stacey Dillree | Prevention Professional | 2800 W Sahara Ave Ste 8b-c, Las Vegas, NV 89102-4390 | 2017-01-16 |
| 1710593223 | Changing Lives LLC | Prevention Professional | 500 N Rainbow Blvd Ste 300, Las Vegas, NV 89107-1061 | 2020-09-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.