# CHANGING LIVES: MIND, BODY, AND SOUL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134394091
- **Authorized official:** MRS. CHRISTIANE PREVILMA BA (OWNER)
- **Authorized official phone:** (954) 274-8611

## Contact information

- **Practice address:** 1356 STRAWBERRY LN, WEST PALM BEACH, FL 33415-4510
- **Practice address phone:** (954) 274-8611
- **Mailing address:** 1356 STRAWBERRY LN, WEST PALM BEACH, FL 33415-4510
- **Mailing address phone:** (954) 274-8611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 311ZA0620X | Adult Care Home Facility | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | — |
| 320700000X | Physical Disabilities Residential Treatment Facility | — | NULL | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 04/22/2008