MEDICARE: LIFE'S CHANGES PALM BEACH COUNTY, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1891388716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE'S CHANGES PALM BEACH COUNTY, INC.

Provider Business Mailing Address
First Line	:	2250 PALM BEACH LAKES BLVD STE 102
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3407
Country	:	US
Telephone Number	:	561-683-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 PALM BEACH LAKES BLVD STE 102
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3407
Country	:	US
Telephone Number	:	561-683-1000
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	BETH BENVENUTI
Credential	:
Telephone Number	:	561-683-1000

Provider Enumeration Date	:	02/12/2021
Last Update Date	:	02/12/2021

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