National Provider Identifier Database

CHANGING LIVES AGENCY
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

CHANGING LIVES AGENCY
5284 FLOYD RD SW UNIT 2079
MABLETON, GA30126-6120
Phone: 678-396-1803
Fax:
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for CHANGING LIVES AGENCY

NPI Number 1457282980
Legal business name
LBN
CHANGING LIVES AGENCY
Authorized official BONIAT JEMISON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 05/25/2026
Last updated 05/25/2026 - About 2 weeks ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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