Organization
LIFE CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRIDGETT LEWIS (CEO)
(334) 614-6336
Entity
Organization
Contact information
Practice address
9 GRANT CIR, PITTSVIEW, AL 36871-2516
(334) 614-6336
Mailing address
9 GRANT CIRCLE, PITTSVIEW, AL 36871-2521
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
1566
AL
Other
Enumeration date
03/14/2013
Last updated
03/14/2013
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