# CHANGING LIVES HEALTH CARE LLC

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

## Provider details

- **NPI number:** 1790253029
- **Authorized official:** JORDON JACKSON (FOUNDER)
- **Authorized official phone:** (414) 477-9466

## Contact information

- **Practice address:** 4911 W GOOD HOPE RD, MILWAUKEE, WI 53223-4840
- **Practice address phone:** (414) 477-9644
- **Mailing address:** 4911 W GOOD HOPE RD, MILWAUKEE, WI 53223-4840

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/05/2018
- **Last updated:** 11/05/2018