LIFE CHANGES - WINSTON SALEM (NPI# 1972870699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972870699 |
| Entity Type | Organization |
| Organization Name | LIFE CHANGES - WINSTON SALEM |
| Practice Address |
1001 S Marshall St Suite 1-75 Winston Salem NC 27101-5852 |
| Mailing Address |
1001 E Wt Harris Blvd Suite P-192 Charlotte NC 28213-4104 |
| Practice Telephone | 7045370096 |
| Practice Fax Number | 7045376080 |
| Mailing Telephone | 7045370096 |
| Mailing Fax Number | 7045376080 |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2011-11-23 |
| Authorized Official Name | MR. CEDRIC MOORE (ADMINISTRATOR) |
| Authorized Official Telephone | 7045370096 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIFE CHANGES HOME CARE, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | HC4410 | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6601750 | 05 |
| Street Address |
1001 S MARSHALL ST SUITE 1-75 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27101-5852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881021798 | Sharmel Yvette Hooper | Registered Nurse | 1001 S Marshall St, Mailbox 27, Winston Salem, NC 27101-5852 | 2013-10-09 |
| 1689932600 | Steven Heywood Diggs | Radiologic Technologist | 1001 S Marshall St, 1-71 Mailbox #2, Winston Salem, NC 27101-5852 | 2012-04-27 |
| 1346515137 | Al Nursing Dba Imani Enterprises | Home Health | 1001 S Marshall St, Suite 1-72, Winston Salem, NC 27101-5852 | 2012-03-13 |
| 1003193889 | Life Changes - Cap Services | Home Health | 1001 S Marshall St, Suite 1-75, Winston Salem, NC 27101-5852 | 2011-11-08 |
| 1043527591 | Fresh Start Behavioral Services LLC | Community/Behavioral Health | 1001 S Marshall St, Suite 230 2-98 Box88, Winston Salem, NC 27101-5852 | 2010-09-04 |
| 1043545577 | Tonya Michelle Moore | Counselor | 1001 S Marshall St, Suite 1-11, Winston Salem, NC 27101-5852 | 2009-10-16 |
| 1992938120 | Positive Innovated Beginnings, LLC | Community/Behavioral Health | 1001 S Marshall St, Suite 2-6, Winston Salem, NC 27101-5852 | 2009-09-04 |
| 1528295391 | One Life At A Time, LLC | In Home Supportive Care | 1001 S Marshall St, Suite 15, Winston Salem, NC 27101-5852 | 2009-06-18 |
| 1669607974 | Hands To Hands Rehabilitation Center, LLC | Community/Behavioral Health | 1001 S Marshall St, Suite 230, Winston Salem, NC 27101-5852 | 2009-05-17 |
| 1104060722 | Reaching New Heights | Community/Behavioral Health | 1001 S Marshall St, Suite 2-48, Winston Salem, NC 27101-5852 | 2009-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421876 | Annie Carolina Mccollum | Occupational Therapist | 3 S Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2020-09-09 |
| 1891321337 | Philippe Ayres | Personal Emergency Response Attendant | 475 Vine St., Bowman Gray Center for Medical Education, Winston-salem, NC 27101 | 2020-03-17 |
| 1497385595 | Aereil Moore | Counselor | 655 West 4th St, Winston Salem, NC 27101 | 2020-01-17 |
| 1619519428 | Brandi Melissa Decriscio | Nurse Practitioner | 1200 N Martin Luther King Jr Drive, Winston-salem, NC 27101 | 2019-10-14 |
| 1316502909 | Burke Street Chiropractic, Pllc | Chiropractor | 1016 Burke St., Winston-salem, NC 27101 | 2019-05-08 |
| 1790349728 | Nakia Carter | Counselor | 1o1o W. Northwest Boulevard, Winston-salem, NC 27101 | 2019-04-25 |
| 1003391251 | Hannah Fortwengler Rainey | Nurse Anesthetist, Certified Registered | Medical Center Blvrd, Winston-salem, NC 27101 | 2018-10-03 |
| 1750875928 | Susan Wilhelm Patterson | Nurse Practitioner | 1200 Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2018-06-20 |
| 1194228049 | Anjanette Gilley Benjamin | Counselor | 650 Highland Ave Ste 1000, Winston Salem, NC 27101 | 2018-03-16 |
| 1376054627 | Paulisha Da-shawna Mcintyre | Social Worker | 650 Highland Ave Ste 101, Winston Salem, NC 27101 | 2017-10-13 |
| Find all providers in zip 27101 | ||||
| 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 |
|---|---|---|---|---|
| 1376140723 | A Lending Hand Home Care Services LLC | Home Health | 1922 S Mlk Jr Dr Ste 203, Winston Salem, NC 27107-1361 | 2020-10-07 |
| 1104442177 | Reco Wilson | Home Health | 5270 Germanton Rd, Winston Salem, NC 27105-1616 | 2020-06-24 |
| 1629692710 | Provision Home Care Agency, LLC | Home Health | 3516 Vest Mill Rd Ste A, Winston Salem, NC 27103-3070 | 2020-06-03 |
| 1386267888 | Nurses Station Home Care LLC | Home Health | 246 Everidge Rd, Winston Salem, NC 27103-6308 | 2020-05-19 |
| 1831719228 | Piedmont Premium Care,llc | Home Health | 500 W 4th St Ste 201f, Winston Salem, NC 27101-2782 | 2020-04-26 |
| 1891330130 | Goodworks Health Management, LLC | Home Health | 3425 S Main St, Winston Salem, NC 27127-5127 | 2019-11-11 |
| 1245873504 | Stay At Home Health Care | Home Health | 1122 E 17th St, Winston Salem, NC 27105-6178 | 2019-10-18 |
| 1225682016 | Olufemi Samuel Akinade | Home Health | 120 Cloverfield Ct, Winston Salem, NC 27127-9756 | 2019-07-30 |
| 1194378067 | Maria A Hickman | Home Health | 1660 Marble St, Winston Salem, NC 27107-1415 | 2019-07-19 |
| 1417422478 | Bumblebee Services | Home Health | 3060 Apollo Dr, Winston Salem, NC 27101-1951 | 2018-10-05 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27101 |
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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.