# CHANGE OF LIFE COMPANION HOMECARE LLC

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

## Provider details

- **NPI number:** 1790256931
- **Authorized official:** MRS. NATASHA D YVETTE DUNN (ADMINISTRATOR DIRECTOR (OWNER))
- **Authorized official phone:** (404) 307-7223

## Contact information

- **Practice address:** 401 TOPAZ TRAIL, PEACHTREE CITY, FAYETTEVILLE, GA 30269
- **Practice address phone:** (404) 307-7223
- **Mailing address:** P.O. BOX 87242, COLLEGE PARK, GA 30337
- **Mailing address phone:** (404) 307-7223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 12/16/2018
- **Last updated:** 12/16/2018