Healthcare Provider Details

I. General information

NPI: 1093605131
Provider Name (Legal Business Name): CHANGING HEARTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 SPRINGFIELD ST STE B8
DAYTON OH
45403-1431
US

IV. Provider business mailing address

1715 SPRINGFIELD ST STE B8
DAYTON OH
45403-1431
US

V. Phone/Fax

Practice location:
  • Phone: 937-723-8854
  • Fax: 937-637-8385
Mailing address:
  • Phone: 937-723-8854
  • Fax: 937-637-8385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: VONNA HINTON
Title or Position: OWNER
Credential: LPN
Phone: 937-723-8854