LIFE CHANGE FAMILY SERVICES INC (NPI# 1518417583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518417583 |
| Entity Type | Organization |
| Organization Name | LIFE CHANGE FAMILY SERVICES INC |
| Practice Address |
20018 N Toledo Ave Maricopa AZ 85138-5359 |
| Practice Telephone | 5203740072 |
| Mailing Telephone | 5203740072 |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |
| Authorized Official Name | MS. CLAUDETTE WALKER (PRESIDENT) |
| Authorized Official Telephone | 5203740072 |
| Authorized Official Credential | BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
BH 5008 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ARIZONA DEPARTMENT OF HEALTH LICENSE | BH 5008 | 01 |
| Street Address |
20018 N TOLEDO AVE |
| City | MARICOPA |
| State | AZ |
| Zip Code | 85138-5359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202594 | Olugus Family Care | Psychologist | 44077 W. Palmen Dr., Maricopa, AZ 85138 | 2020-10-15 |
| 1154960722 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 41840 W Maricopa- Casa Grande Hwy, Maricopa, AZ 85138 | 2019-12-31 |
| 1780227413 | Gabriela Flores | Registered Nurse | 44150 W. Maricopa Casa Grande Hwy, Maricopa, AZ 85138 | 2019-10-25 |
| 1033752761 | Lizabeth Joy Stephens | Registered Nurse | 44150 West Maricopa-casa Grand Hwy., Maricopa, AZ 85138 | 2019-10-25 |
| 1922657964 | Cathy Jo Rogers | Registered Nurse | 18600 North Porter Road, Maricopa, AZ 85138 | 2019-09-11 |
| 1902463565 | Four Directions LLC | Respite Care | 37724 W Amalfi Ave, Maricopa, AZ 85138 | 2019-05-20 |
| 1972087013 | Kristina Donnay | Family Medicine | 41600 W Smith Enke Rd Ste 3, Maricopa, AZ 85138 | 2018-09-24 |
| 1861909657 | Four Directions LLC | Respite Care | 43989 W Wade Drive, Maricopa, AZ 85138 | 2018-01-03 |
| 1063939411 | Christina Kern | Specialist/Technologist | 42623 W. Colby Dr., Maricopa, AZ 85138 | 2017-08-26 |
| 1205357191 | Konadu Family | Community Based Residential Treatment Facility, Mental Illness | 40030 W Coltin Way, Maricopa, AZ 85138 | 2017-06-29 |
| Find all providers in zip 85138 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437401536 | The Haven | Substance Abuse Rehabilitation Facility | 1015 E Adelaide Dr, Tucson, AZ 85719-2605 | 2012-10-12 |
| 1033497276 | Arivaca Ranch LLC | Substance Abuse Rehabilitation Facility | 38000 South Arivaca Ranch Road, Arivaca, AZ 85601 | 2011-07-21 |
| 1275861007 | Mhcti LLC | Substance Abuse Rehabilitation Facility | 3771 E Brooks Farms Rd, Gilbert, AZ 85298-5811 | 2009-12-07 |
| 1679800106 | Westcare Arizona I, Inc. | Substance Abuse Rehabilitation Facility | 1800 Rio Vista Dr, Bullhead City, AZ 86442-7229 | 2009-11-04 |
| 1578736039 | Tri-phase Group Home Inc | Substance Abuse Rehabilitation Facility | 111 S Lazona Dr, Mesa, AZ 85204-1222 | 2008-04-04 |
| 1043483704 | Tri-phase Group Inc | Substance Abuse Rehabilitation Facility | 2355 E Elmwood St, Mesa, AZ 85213-5909 | 2008-04-02 |
| 1396914735 | Tri-phase Group Home Inc | Substance Abuse Rehabilitation Facility | 1575 E Betsy Ln Unit D, Gilbert, AZ 85296-3759 | 2008-02-28 |
| 1487862959 | Navajo Nation Department of Behavioral Health Services | Substance Abuse Rehabilitation Facility | Navajo Route 7, Duplex 2003, Chinle, AZ 86503-0777 | 2007-05-18 |
| 1780809376 | American Indian Prevention Coalition | Substance Abuse Rehabilitation Facility | 1902 N 23rd St, Phoenix, AZ 85006-2428 | 2007-04-17 |
| 1114141918 | American Indian Prevention Coalition | Substance Abuse Rehabilitation Facility | 1622 N 27th Pl, Phoenix, AZ 85008-3610 | 2007-04-12 |
| 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.