Organization
CHANGING LIVES: MIND, BODY, AND SOUL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTIANE PREVILMA BA (OWNER)
(954) 274-8611
Entity
Organization
Contact information
Practice address
1356 STRAWBERRY LN, WEST PALM BEACH, FL 33415-4510
(954) 274-8611
Mailing address
1356 STRAWBERRY LN, WEST PALM BEACH, FL 33415-4510
(954) 274-8611
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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