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General NPI Number Information
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NPI Number | 1609645407
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Entity Type | Organization
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Legal Business Name | CHANGING LIVES INCORPORATION
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Dates
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Enumeration Date | 12/21/2023
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 581 KATHRYN CT
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City | CLARKSVILLE
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State | TN
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Zip | 37042-7148
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Country | US
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Telephone | 270-697-0727
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Fax |
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Provider Business Mailing Address
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Address Line | 581 KATHRYN CT
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City | CLARKSVILLE
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State | TN
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Zip | 37042-7148
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Country | US
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Telephone | 270-697-0727
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. PATRICIA DIANE LEGGS
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Credential |
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Telephone | 270-697-0727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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