Healthcare Provider Details

I. General information

NPI: 1861314791
Provider Name (Legal Business Name): CHANGE GAIN ACHIEVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 NW 183RD ST
MIAMI FL
33169-4516
US

IV. Provider business mailing address

PO BOX 612816
MIAMI FL
33261-2816
US

V. Phone/Fax

Practice location:
  • Phone: 786-859-5035
  • Fax:
Mailing address:
  • Phone: 305-859-1638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: SHENEKA ALEXANDER
Title or Position: OWNER
Credential:
Phone: 305-859-1638