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General NPI Number Information
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NPI Number | 1487190328
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Entity Type | Organization
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Legal Business Name | CHANGING LIVES HOME HEALTHCARE SERVICE
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 1839 ROCKMOOR DR
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5414
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Country | US
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Telephone | 314-489-5552
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Fax |
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Provider Business Mailing Address
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Address Line | 1839 ROCKMOOR DR
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5414
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Country | US
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Telephone | 314-489-5552
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. KELLEY PEARSON
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Credential | LPN
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Telephone | 314-489-5552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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