# LIFE CHANGEZ INC

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

## Provider details

- **NPI number:** 1730441775
- **Authorized official:** MISS RENE COFER WHITEHEAD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (919) 538-8920

## Contact information

- **Practice address:** 5321 LOGOS CT, RALEIGH, NC 27610-3481
- **Practice address phone:** (919) 803-7125
- **Practice address fax:** (919) 803-2808
- **Mailing address:** 1100 LOGGER CT STE A102, RALEIGH, NC 27609-8506
- **Mailing address phone:** (919) 803-2799
- **Mailing address fax:** (919) 803-2808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | — | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-092-844 | NC | Yes |

## Other

- **Enumeration date:** 06/14/2012
- **Last updated:** 09/30/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6604442 | — | NC |