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Organization
CHANGING HOW I LIVE LIFE
Active
Organization
CHANGING HOW I LIVE LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LORI D. WILSON LCDC (EXECUTIVE DIRECTOR)
(512) 385-4799
Entity
Organization
Contact information
Practice address
1006 E YAGER LN, A 104, AUSTIN, TX 78753-7088
(512) 385-4799
Mailing address
1006 E. YAGER LANE, A 104, AUSTIN, TX 78753
(512) 385-4799
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
TX
251B00000X
Case Management Agency
—
NULL
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
5006
TX
253Z00000X
In Home Supportive Care Agency
—
NULL
Other
Enumeration date
03/04/2010
Last updated
09/14/2016
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