MEDICARE: MY CHANGE IS COMING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	343900000X	Non-emergency Medical Transport (VAN)
2	347C00000X	Private Vehicle
3	385H00000X	Respite Care
4	305S00000X	Point of Service

General Provider Information

NPI Number	:	1063870392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY CHANGE IS COMING, INC.

Provider Business Mailing Address
First Line	:	PO BOX 380297
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75138-0297
Country	:	US
Telephone Number	:	214-642-3146
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 BROOKWOOD DR
Second Line	:
City	:	DUNCANVILLE
State	:	TX
Zip	:	75116-4504
Country	:	US
Telephone Number	:	214-642-3146
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM MANAGER
Name	:	AUDRY CATRICE HAYDEN
Credential	:
Telephone Number	:	214-642-3146

Provider Enumeration Date	:	02/01/2016
Last Update Date	:	02/01/2016

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Directions to “MY CHANGE IS COMING, INC. ” Practice Location

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