Healthcare Provider Details

I. General information

NPI: 1033080791
Provider Name (Legal Business Name): A CHANGING HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 N SHADELAND AVE STE D
INDIANAPOLIS IN
46219-4825
US

IV. Provider business mailing address

916 N SHADELAND AVE STE D
INDIANAPOLIS IN
46219-4825
US

V. Phone/Fax

Practice location:
  • Phone: 317-746-6676
  • Fax: 317-737-2019
Mailing address:
  • Phone: 317-746-6676
  • Fax: 317-737-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RHONDA LONG
Title or Position: CEO
Credential:
Phone: 317-746-6676