Organization
THE LIFE CHANGE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN ZELLER D.O. (MEDICAL DIRECTOR)
(775) 499-5534
Entity
Organization
Contact information
Practice address
1201 N STEWART ST STE 120, CARSON CITY, NV 89706-3004
(775) 350-7250
(775) 461-3570
Mailing address
1755 SULLIVAN LN, SPARKS, NV 89431-2815
(775) 499-5534
(775) 499-5535
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
8312NTC-0
NV
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
12/16/2015
Last updated
06/17/2024
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