LIFE CHANGE OUTREACH ORGANIZATION, INC (NPI# 1225401912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225401912 |
| Entity Type | Organization |
| Organization Name | LIFE CHANGE OUTREACH ORGANIZATION, INC |
| Practice Address |
15508 Willet Ct Mascotte FL 34753-9102 |
| Practice Telephone | 3522722799 |
| Practice Fax Number | 3524106111 |
| Mailing Telephone | 3522722799 |
| Mailing Fax Number | 3524106111 |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |
| Authorized Official Name | MR. ANTHONY A ANDERSON (PRESIDENT) |
| Authorized Official Telephone | 3522722799 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982036133 | Life Change Outreach Organization, Inc | Home Health | 55 Bluff Lake Rd, Suite A, Mascotte, FL 34753-9501 | 2013-07-30 |
| Street Address |
15508 WILLET CT |
| City | MASCOTTE |
| State | FL |
| Zip Code | 34753-9102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700134715 | Nabuchi Grace Anderson | Counselor | 15508 Willet Ct, Mascotte, FL 34753-9102 | 2012-08-22 |
| 1538614540 | Grace's Support Services, LLC | Case Manager/Care Coordinator | 15508 Willet Ct, Mascotte, FL 34753-9102 | 2016-08-19 |
| 1992057723 | Life Change Outreach Organization | Case Manager/Care Coordinator | 15508 Willet Ct, Mascotte, FL 34753-9102 | 2012-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336347426 | Takita's Helping Hand | Day Training, Developmentally Disabled Services | 255 Boca Ciega Rd, Mascotte, FL 34753 | 2007-07-10 |
| 1871070920 | Justo Nual Perez | Registered Nurse | 16 Lake Jackson Dr, Mascotte, FL 34753-8806 | 2018-07-22 |
| 1285863589 | Andrea Geraldine Delph | Occupational Therapist | 5136 Pine Needle Dr, Mascotte, FL 34753-8867 | 2009-07-08 |
| 1114479367 | Jamie Small | Behavior Technician | 301 Boca Ciega Rd, Mascotte, FL 34753-9224 | 2016-11-03 |
| 1174825210 | Lazina Johannah Thomas | Case Manager/Care Coordinator | 315 Carol St, Mascotte, FL 34753-9253 | 2010-11-22 |
| 1982036133 | Life Change Outreach Organization, Inc | Home Health | 55 Bluff Lake Rd, Suite A, Mascotte, FL 34753-9501 | 2013-07-30 |
| 1548723356 | Anthony Alan Anderson | Case Manager/Care Coordinator | 55 Bluff Lake Rd, Mascotte, FL 34753-9536 | 2019-04-09 |
| 1386107100 | Redefining Abilities LLC | Case Manager/Care Coordinator | 55 Bluff Lake Rd, Mascotte, FL 34753-9536 | 2019-04-09 |
| 1619535655 | Antonio Norat Jr. | Driver | 16033 Worthington Blvd N, Mascotte, FL 34753-9613 | 2019-06-04 |
| 1427601640 | A.n.j Transport L.L.C. | Non-emergency Medical Transport (VAN) | 16033 Worthington Blvd N, Mascotte, FL 34753-9613 | 2019-07-17 |
| Find all providers in zip 34753 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982036133 | Life Change Outreach Organization, Inc | Home Health | 55 Bluff Lake Rd, Suite A, Mascotte, FL 34753-9501 | 2013-07-30 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.