LIFE CHANGE CORP; NPI #1700697976

Contact Information

LIFE CHANGE CORP

2995 W FAIRMOUNT AVE
PHOENIX, AZ 85017-4614

Phone: 602-799-2757
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Urgent Care	261QU0200X
Community Health	261QC1500X
Community/Behavioral Health	251S00000X
General Practice	208D00000X	99	Physician/Undefined Physician type[6]
Health Service	261QH0100X
In Home Supportive Care	253Z00000X
Mental Health	101YM0800X
Physical Medicine & Rehabilitation	208100000X	25	Physician/Physical Medicine and Rehabilitation
Primary Care	261QP2300X
Professional	101YP2500X
Psychiatry	2084P0800X	26	Physician/Psychiatry
Rehabilitation, Substance Use Disorder	261QR0405X

Indicates primary specialty

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NPI Profile & details for LIFE CHANGE CORP

NPI #	`1700697976`
LBN Legal business name	LIFE CHANGE CORP
Authorized official	TLAHJONTE HOPSON - (BOARD CHAIRMAN)
Entity	Organization
Organization subpart ¹	No
Enumeration date	01/16/2025
Last updated	01/06/2026 - About 5 months ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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LIFE CHANGE CORP

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NPI Profile & details for LIFE CHANGE CORP

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