# LIFE CHANGE OUTREACH ORGANIZATION, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LCO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982036133
- **Authorized official:** MRS. NABUCHI G ANDERSON REGISTERED MHC (PROGRAM MANAGER, OWNER)
- **Authorized official phone:** (352) 255-6458

## Contact information

- **Practice address:** 55 BLUFF LAKE RD, SUITE A, MASCOTTE, FL 34753-9501
- **Practice address phone:** (352) 255-6458
- **Practice address fax:** (352) 410-6118
- **Mailing address:** 55 BLUFF LAKE RD, SUITE A, MASCOTTE, FL 34753-9501
- **Mailing address phone:** (352) 255-6458
- **Mailing address fax:** (352) 410-6118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 251E00000X | Home Health Agency | 232916 | FL | — |
| 253Z00000X | In Home Supportive Care Agency | 232916 | FL | — |

## Other

- **Enumeration date:** 07/30/2013
- **Last updated:** 07/30/2013